Objective To investigate the prevalence and molecular characteristics of Anaplasma infections in sheep and goats in Anhui Province in 2020, so as to provide insights into ovine anaplasmosis prevention and control. Methods A total of 355 fresh blood samples were collected from 7 sheep and goat farms in Linquan County of Fuyang City, Lixin County of Bozhou City, Yu'an District of Lu'an City, Wangjiang County of Anqing City, Nanling County of Wuhu City, and Tianchang City and Fengyang County of Chuzhou City in Anhui Province from June to December 2020. A. bovis and A. phagocytophilum 16S ribosomal RNA (16S rRNA) gene, A. ovis major surface protein 4 (MSP4) gene and A. capra citric acid synthase (gltA) gene were amplified using PCR assay in all blood samples, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was calculated in sheep and goats. In addition, the positive amplification products were sequenced and subjected to genetic evolutionary analysis. Results The overall prevalence of Anaplasma infections was 17.5% (62/355) in sheep and goats in Anhui Province, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was 2.8% (10/355), 2.5% (9/355), 2.5% (9/355), and 7.0% (25/355), while the prevalence of A. bovis and A. phagocytophilum, A. phagocytophilum and A. ovis, A. phagocytophilum and A. capra and A. bovis, A. phagocytophilum and A. ovis co-infections was 0.8% (3/355), 1.1% (4/355), 0.3% (1/355) and 0.3% (1/355), respectively. No Anaplasma was detected in the sheep and goat farms in Fengyang County, while at least three Anaplasma species were detected in other sheep and goat farms, with co-infections of multiple Anaplasma species identified. The prevalence of Anaplasma infections was 14.7% (24/163) in goats and 19.8% (38/192) in sheep, and the prevalence of Anaplasma infections was 31.0% (31/100) in goats and sheep under 6 months of age, and 12.2% (31/255) in goats and sheep at ages of 6 months and older, respectively. A. bovis, A. phagocytophilum, A. ovis and A. capra were identified in sheep and goats of different breeds and ages. Conclusions Multiple Anaplasma species infections were commonly prevalent in goats and sheep in Anhui Province in 2020, notably A. phagocytophilum, A. ovis and A. capra, which have zoonotic risks. Improved surveillance and prevention and control of Anaplasma infections are required in sheep and goats in Anhui Province.

The pre-hospitalization service is an important initiative for medical institutions to implement the national reform of the medical security system. In 2018, Zhejiang province proposed the " most run once reform", requiring the establishment of an admission preparation center to carry out pre-hospitalization services. In June 2021, a certain maternal and child health hospital conducted a process reengineering for the pre admission process of the admission preparation center by applying the combined process analysis and failure mode and effects analysis, high-risk points of the hospitalization process were screened, the job value and job functions of each sector were sorted out, and the sector for improvement sector was evaluated, to launch an independent information system, establish a one click automatic import of pre hospital medical orders function, and remove on-site billing physicians from various specialties for improvement measures. The steps of the process had been optimized, inlcuding issuing pre hospital medical orders, waiting for pre-hospitalization, pre-hospitalization, and so on. The completeness rate of pre hospital medical orders, average waiting days before hospitalization, and patient satisfaction scores of pre hospitalization centers had changed from 91%, 2.99 days, and 93.46 points before process reengineering to 92%, 2.44 days, and 95.80 points after reengineering, respectively. This practice had achieved dual improvements in pre admission service quality and efficiency, so as to provide a reference for China′s medical institutions to carry out safe and efficient pre admission services.

Optimizing pre-hospitalized services is a powerful measure for hospitals to improve patient experience. In June 2022, a certain maternal and child health hospital had carried out a value chain management for pre-hospitalized patient communication based on patient needs. The Kano model and value chain theory were used to analyze the patient demand attributes, clarify the value-added activities of pre-hospitalized patient communication value chain, and implement value-added activities, including carrying out the GLTC doctor-patient communication model, optimizing the information management system of the admission preparation center, establishing a hospital preparation group management platform, and introducing the " Zhejiang Nursing" platform, to achieve the added value of key value chains in patient communication, improve the quality of pre-hospitalized services, and improve patient experience. After one year of practice, the pre-hospitalized patient management indexes, including the unregistration rate after issuing the hospitalization certificate, the cancellation rate after registration, and the average length of stay had decreased from 9%, 3%, and 4.65 days before practice (June 2021 to May 2022) to 6%, 1%, and 4.13 days after practice (June 2022 to May 2023), respectively. As well as the timely completion rate of pre-hospital inspection and the average satisfaction rate of pre-hospitalized patients had increased from 93% and 94% to 98% and 97%, respectively. The practice had achieved good application effects, so as to provide references for improving the level of pre-hospitalized services and improving the patient experiences in medical institutions in our country.

Cells utilize calcium ions (Ca) to signal almost all aspects of cellular life, ranging from cell proliferation to cell death, in a spatially and temporally regulated manner. A key aspect of this regulation is the compartmentalization of Ca in various cytoplasmic organelles that act as intracellular Ca stores. Whereas Ca release from the large-volume Ca stores, such as the endoplasmic reticulum (ER) and Golgi apparatus, are preferred for signal transduction, Ca release from the small-volume individual vesicular stores that are dispersed throughout the cell, such as lysosomes, may be more useful in local regulation, such as membrane fusion and individualized vesicular movements. Conceivably, these two types of Ca stores may be established, maintained or refilled via distinct mechanisms. ER stores are refilled through sustained Ca influx at ER-plasma membrane (PM) membrane contact sites (MCSs). In this review, we discuss the release and refilling mechanisms of intracellular small vesicular Ca stores, with a special focus on lysosomes. Recent imaging studies of Ca release and organelle MCSs suggest that Ca exchange may occur between two types of stores, such that the small stores acquire Ca from the large stores via ER-vesicle MCSs. Hence vesicular stores like lysosomes may be viewed as secondary Ca stores in the cell.

Objective To investigate the effect of pyrin domain 3 (NLRP3) inflammasome in the process of contrast induced human kidney cell apoptosis.Methods Human kidney 2 (HK-2) cells were cultured in DMEM-F12 medium with 5％ FBS.Cells were divided into control group,Contrast group (O group),NLRP3-siRNA+Iohexol group (si-NLRP3+O group),ASC-siRNA+Iohexol group (si-ASC+O group),and mannitol group (M group).Different concentrations of hypotonic contrast agent were added to HK-2 cell culture plates for 24,48 and 72 h.Flow cytometry was used to detect apoptosis.NLRP3 and ASC mRNA expressions were detected by RT-PCR.The expressions of NLRP3,ASC,caspase-8/cleaved caspase-8,Bcl-2/Bax,caspase-1/cleaved caspase-1,and caspase-3/cleaved caspase-3 protein were detected by Western blot.The levels of interleukin (IL) 1β and IL-18 in supernatant were detected by ELISA.Results Compared with the control group,the rate of apoptotic cells,as well as the expressions of NLRP3,ASC and cleaved caspase-1 proteins were increased in HK-2 cells of contrast group.The expressions of NLRP3 and ASC mRNA in the contrast group also increased,so did IL-1β and IL-18 levels (all P＜0.05),suggesting that NLRP3 inflammasome in HK-2 cells was activated by contrast.Compared with the control group,the expressions of cleaved caspase-8,Bax and cleaved caspase-3 protein were increased,and the expression of anti-apoptotic protein Bcl-2 was decreased (all P ＜ 0.05).Compared with the contrast group,the rate of apoptotic cells in the si-NLRP3 + contrast group and si-ASC + contrast group was significantly decreased;the expression of cleaved caspase-1 was decreased;the expressions of Bax and cleaved caspase-3 were decreased,and Bcl-2 level was increased.The expressions of IL-1β and IL-18 in the supernatant of cells were decreased (all P ＜ 0.05).Conclusion Contrast agent can activate the NLRP3 pathway in HK-2 cells and induce apoptosis,which could be reduced by blocking the NLRP3 pathway.

Objective To evaluate the effect of intrathecal dexmedetomidine on expression of sub-stance P (SP) and c-fos in the spinal dorsal horns of rats with visceral pain. Methods Thirty-two clean-grade healthy adult male Sprague-Dawley rats, weighing 250-300 g, were divided into 4 groups ( n=8 each) using a random number table method: control group (C group), visceral pain group (VP group), dexmedetomidine group (D group) and dexmedetomidine plus atipamezole group (DA group). VP, D and DA groups received intraperitoneal injection of 0. 9％ acetic acid 10 ml∕kg to establish the model of visceral pain, while group C received the equal volume of normal saline instead. At 10 min before the model was es-tablished, dexmedetomidine 20 μl (1μg∕kg) and dexmedetomidine 1μg∕kg plus atipamezole 1μg∕kg (20μl) were intrathecally injected in D and DA groups, respectively, and the equal volume of normal saline 20μl was given instead in C and VP groups. Visceral pain index ( VPI) was recorded at 1 h after intraperito-neal injection, and then rats were sacrificed, and the dorsal horns of the spinal cord ( L4-6 ) were removed for determination of the expression of SP and c-fos by immunohistochemistry. Results Compared with group C, VPI was significantly increased, and the expression of SP and c-fos was up-regulated in VP, D and DA groups (P<0. 05). Compared with group VP, VPI was significantly decreased, and the expression of SP and c-fos was down-regulated in D and DA groups (P<0. 05). Compared with group D, VPI was signifi-cantly increased, and the expression of SP and c-fos was up-regulated in group DA ( P<0. 05) . Conclusion Intrathecal dexmedetomidine reduces the visceral pain through inhibiting the expression of SP and c-fos in the spinal dorsal horns, which is related to the α2-adrenergic receptor in spinal dorsal horns of rats.

Objective To discuss the application of informed consent of skin care. Methods The informed consent of skin care was designed by nurses themselves. Informed consent of skin care was applied in the nursing of critically ill patients from October 2013 to August 2014. Comparisons were conducted before and after the use of informed consent of skin care. Results After the application of the informed consent of skin care, there was no complaints while the incidence of complaints was 9. 86% before the application of informed consent of skin care (P<0. 05). Family satisfaction of the skin care was higher than before the application of the informed consent of skin care (98. 4% and 87. 3%) (P <0. 05). Conclusions The application of the informed consent of skin care can improve the quality of skin care in critically ill patients, enhance the relationship between nurse and patient, increase the satisfaction of skin care.

Objective:To explore application of targeted contrast enhanced ultrasonography in diagnosis of early stage vascular endothelial injury and diabetic nephropathy.Methods:Targeted SonoVue-TM microbubble was prepared by attaching anti-TM monoclonal antibody to the surface of ordinary micro-bubble SonoVue by biotin-avidin bridge method and ultrasonic instrument was used to evaluate the developing situation of targeted microbubble in vitro. Twenty 12-week-old male GK rats and 20 Wistar rats were enrolled in this study, and were randomly divided into targeted angiography group and ordinary angiography group. Targeted microbubbles SonoVue-TM or general microbubble SonoVue were rapidly injected to the rats via tail vein; the developing situation of the two contrast agents in rats kidneys was dynamically observed. Time intensity curve was used to analyse rat kidney perfusion characteristics in different groups. Results:Targeted ultrasound microbubble SonoVue-TM was successfully constructed, and it could be used to develop an external image. Targeted microbubbles SonoVue-TM enabled clear development of experimental rat kidney. Time intensity curve shapes of rat kidney of the two groups showed as single apex with steep ascending and slowly descending branch. Compared with the control group, the rising slope of the GK rat renal cortex, medulla in targeted angiography group increased(P<0.05); the peak intensity of medulla increased (P<0.05), and the total area under the curve of medulla increased (P<0.05). Compared with control group, the ascending branch of the GK rat in renal cortex, medulla in ordinary angiography group increased (P<0.05). The peak intensity of the curve increased (P<0.05), and the total area under the curve increased (P<0.05). Compared with the ordinary angiography group, the peak of GK rat medullacurve in targeted angiography group intensity increased (P<0.05), and the total area under the curve increased (P<0.05).Conclusions:Targeted microbubbles SonoVue-TM can make a clear development of experimental rat kidney, its stable performance meet the requirement of ultrasonic observation time limit, and it can reflect early changes of blood perfusion in GK rat kindey.

Objective To study the changes of hearing function and cochlear morphology on diffuse brain in-jury model in rat .Methods One hundred and fifty SD rats with normal hearing were randomly divided into five groups ,each group consisted of 30 SD rats ,including a control group and four experimental groups which endured diffuse brain injury(DBI) from one to four weeks .Diffuse brain injury model of rats were established ,then ABR , 40 Hz AERP and ASSR examination ,light microscopy ,electron microscopy were used to evaluate the change of hearing function and morphology .Results The difference of ABR ,40 Hz AERP and ASSR thresholds between the experimental and the normal control group were significant (P<0 .05) .The thresholds of ABR ,40HzAERP and AS-SR were increased in the first week of DBI ,then the threshold continuously increased in the second and third week , at last the threshold decreased in the fourth week .The results under scaning electron microscope demonstrated that the ciliums of the majority of outer hair cells lodged in the first week of DBI .The results under transmission electron microscope showed that in the first week of DBI ,there were edema and denuration of mitochondrial ,mitochondrial cristaes were obscured or disappeared .The changes were deteriorate in the second and third week ,whereas the changes were mitigatal in the fourth week .Conclusion Cochlear morphology and hearing damage were observed in diffuse brain injury model of rats .

OBJECTIVE: To study the effects of different types of prosthesis used in ossiculoplasty on mastoidectomy of treating chronic otitis media. METHOD: One hundred and forty three patients with chronic otitis media were treated by canal wall-down tympanoplasty with ossiculoplasty in a single stage. According to material of prosthesis, they were classified as titanium group (group A, 52 cases), hydroxypatite group (group B, 47 cases) and autogenous bone group(group C, 44 cases). The postoperative complication and hearing thresholds were analyzed in the 24 months follow-up. Average postoperative air-conduction gain and air-bone gap were measured at four frequencies: 0.5, 1.0.2, and 4.0 kHz. RESULT: 12-month after operation, the average air threshold and air-bone gaps of the three groups were reduced (P < 0.05). The reconstruction successful rate (78.7%) of group A was slightly better than that of B, C (68.1%, 70.4%), there was no statistically significant difference. The difference of the average air threshold and air-bone gaps of group B, C after 24-month of operation and 12-month after operation was statistically significant (P < 0.05). The reconstruction successful rate (48.9%, 45.5%) of group B, C was lower than that of A (76.9%), the difference was also statistically significant (P < 0.05). CONCLUSION Prostheses using titanium type could give good functional results and strong stability with low complication.
Adult ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Ossicular Prosthesis ; classification ; Ossicular Replacement ; instrumentation ; methods ; Otitis Media ; surgery ; Titanium ; Treatment Outcome