Objective:To observe the recurrence condition of hepatitis B in different risk groups after liver transplantation in an attempt to provide useful information on whether to discontinue hepatitis B immunoglobulin (HBIG) in the future at an early stage.Methods:The patient population was divided into high, low-risk, and special groups [especially primary hepatocellular carcinoma (HCC)] according to the guidelines for the prevention and treatment of hepatitis B recurrence after liver transplantation. The recurrence condition and risk factors in this population were observed for hepatitis B. Measurement data were analyzed using a t-test and a rank-sum test. Count data were compared using a χ2 test between groups. Results:This study finally included 532 hepatitis B-related liver transplant cases. A total of 35 cases had HBV recurrence after liver transplantation, including 34 cases that were HBsAg positive, one case that was HBsAg negative, and 10 cases that were hepatitis B virus (HBV) DNA positive. The overall HBV recurrence rate was 6.6%. The recurrence rate of HBV was 9.2% and 4.8% in the high- and low-risk HBV DNA positive and negative groups before surgery ( P = 0.057). Among the 293 cases diagnosed with HCC before liver transplantation, 30 had hepatitis B recurrence after surgery, with a recurrence rate of 10.2%. The independent related factors for the recurrence of hepatitis B in patients with HCC after liver transplantation were HCC recurrence ( HR =181.92, 95% CI 15.99~2 069.96, P < 0.001), a high postoperative dose of mycophenolate mofetil dispersible tablets (MMF) ( HR =5.190, 95% CI 1.289~20.889, P = 0.020), and a high dosage of HBIG ( HR = 1.012, 95% CI 1.001~1.023, P = 0.035). Among the 239 cases who were non-HCC before liver transplantation, five cases (recurrence rate of 2.1%) arouse postoperative hepatitis B recurrence. Lamivudine was used in all cases, combined with on-demand HBIG prophylaxis after surgery. There was no hepatitis B recurrence in non-HCC patients who treated with entecavir combined with HBIG after surgery. Conclusion:High-barrier-to-resistance nucleotide analogues combined with long-term HBIG have a good effect on preventing the recurrence of hepatitis B after liver transplantation. The discontinuation of HBIG may be considered at an early stage after administration of a high-barrier-to-resistance nucleotide analogue in low-risk patients. Domestically, the HBV infection rate is high, so further research is still required to explore the timing of HBIG discontinuation for high-risk patients, especially those with HCC.

This study aims to investigate the function of lmo2363 gene in stress resistance of Liste-ria monocytogenes strain LM83-1.In this study,the lmo2363 gene deletion strain and complement-ation strain of Listeria monocytogenes were constructed using overlapping extended PCR and ho-mologous recombination techniques,and the growth ability,stress survival rate and biofilm forma-tion ability of wild,deletion strain and complementation strain were compared under different stress environments.lmo2363 gene deletion strain and complementation strain of Listeria monocy-togenes were successfully constructed in this experiment.The growth curves showed that the growth capacity of the deletion strain was weaker than the wild strain LM83-1 under 4 ℃,7％NaCl,10％NaCl,3.5％ethanol,4.0％ethanol and pH5 stress(P＜0.001).The results of stress survival test showed that the survival rate of the deletion strain was significantly lower than the wild strain after 1 h treatment with pH3 and 10 mmol/L H2 O2 stress(P＜0.010).The biofilm forming ability of the deletion strain was decreased compared with that of the wild strain(P＜0.050).This study confirmed that lmo2363 gene mediated the adaptation of LM to low temperature,high osmotic pressure,ethanol and acid stress environment and affected the formation of LM bio-film.This study laid a foundation for further exploring the function of lmo2363 gene in the stress resistance process of Listeria monocytogenes.

Objective To investigate the potential categories of exercise perception in patients with end-stage renal disease(ESRD),and analyze the relationship between different latent categories and change in physical activity,so as to provide references for targeted intervention.The latent profile analysis was used to extract potential categories of exercise perception,and multiple linear regression analysis was conducted with potential categories as independent variables and change in physical activity as dependent variables.Methods A total of 265 ESRD patients from a tertiary hospital were selected from June 2022 to May 2023 by convenience sampling method.The general data questionnaire,the Dialysis Patient-perceived Exercise Benefits and Barriers Scale(DPEBBS)and the Measuring Change in Physical Activity Questionnaire(MCPAQ)were used for investigation.Results A total of 241 ESRD patients completed the survey.The results of multiple linear regression analysis showed that education level,family per capita monthly income and potential categories of exercise perception were the influencing factors of change in physical activity in ESRD patients(P＜0.05).Conclusion There was group heterogeneity in the exercise perception in patients with ESRD.Clinical workers should give targeted intervention according to the potential categories of patients'exercise perception,so as to promote the initiation and long-term maintenance of the change in physical activity.

Objective:With the development of perinatal and neonatal intensive care medicine,the survival rate of very premature infants increases year by year.However,the incidence of bronchopulmonary dysplasia(BPD)increases year by year,which seriously affects the survival prognosis of very premature infants.How to prevent and treat BPD effectively has become the focus of neonatologists.This study aims to provide ideas for the prevention and treatment of BPD in very preterm infants via analyzing the clinical characteristics of BPD. Methods:A total of 472 cases of very premature infants admitted to the Divison of Neonatology,Department of Pediatrics at the Second Xiangya Hospital of Central South University were retrospectively selected and assigned into a BPD group(n=147)and a non-BPD group(n=325)according to the diagnosis of BPD.Clinical data of each group were collected to find out the clinical characteristics of BPD in very preterm infants.Basic information,maternal pregnancy data,laboratory findings,nutritional support,respiratory support patterns and duration,and systemic complications were included. Results:Compared with the non-BPD group,gestational age,birth weight,head circumference and body length in the BPD group were lower,the Apgar score in 1st min and 5th min and average body weight growth rate were lower(all P<0.05);the ratios of male,very low birth weight(VLBW),and extremely low birth weight(ELBW)in the BPD group were higher than those in the non-BPD group(all P<0.5);the incidence of maternal cervical insufficiency and the rate of using embryo transfer technology in the BPD group were higher than those in the non-BPD group,and the rate of using prenatal hormone in the BPD group was lower than that in the non-BPD group(all P<0.05).The positive rate of sputum culture in the BPD group was higher than that in the non-BPD group(P<0.05),and the white blood cell count,neutrophil ratio,and procalcitonin in the BPD group were higher than those in the non-BPD group(all P<0.05).The period of fasting,minimal feeding,total parenteral nutrition(TPN),and partial parenteral nutrition(PPN)in the BPD group were longer than those in the non-BPD group(all P<0.05).The duration of nasal catheter oxygen inhalation and mechanical ventilation in the BPD group was longer than that in the non-BPD group,and the rates of mechanical ventilation at Day 1,3,7,14,21 and 28 after birth were higher than those in the non-BPD group(all P<0.05).The incidence of respiratory distress syndrome,apnea of prematurity,respiratory failure,pneumonia,pulmonary hemorrhage,pleural effusion,persistent pulmonary hypertension,hemodynamic patent ductus arteriosus,cytomegalovirus infection,neonatal necrotic enterocolitis,cholestasis,anemia,abnormal blood system,hypothyroidism,retinopathy of prematurity,and internal environment disorders in the BPD group were significantly higher than those in non-BPD group(all P<0.05). Conclusion:There are significant differences between very premature infants with BPD and those without BPD in general information,maternal history,inflammatory indicators,nutritional support,respiratory support,comorbidities and complication rates.To ensure normal fetal development,reducing the inflammatory reaction of very premature infants,establishing enteral nutrition as early as possible,shortening the time of mechanical ventilation,and reducing the occurrence of complications are beneficial to decrease the incidence of BPD in very premature infants and improve the long-term prognosis of BPD.

Objective:To study the clinical characteristics of different types of neonatal sepsis.Methods:From January 2012 to December 2019, neonates with confirmed sepsis from 5 neonatal centers of central-south China were reviewed. The neonates were assigned into early-onset sepsis (EOS) and late-onset sepsis (LOS) group, and the latter was further subgrouped into hospital-acquired LOS (hLOS) group and community-acquired LOS (cLOS) group. The etiological and clinical characteristics were analyzed. SPSS 26.0 was used for statistical analysis.Results:A total of 580 neonates were enrolled, including 286 (49.3%) in the EOS group and 294 (50.7%) in the LOS group. In LOS group, 147 were in hLOS group and 147 were in cLOS group. The gestational age and birth weight of hLOS group were significantly lower than the other two groups [(32.7±3.6) weeks vs. (37.1±3.7) weeks and (37.7±3.0) weeks, (1 810±717) g vs. (2 837±865) g and (3 024±710) g] ( P<0.05). The common pathogens in EOS and cLOS groups were coagulase-negative staphylococci and Escherichia coli, while Klebsiella pneumoniae was common in hLOS group. Carbapenems usage in the hLOS group was significantly higher than the other two groups [62.6% vs. 28.7% and 16.2%] ( P<0.05). Antibiotics duration in the hLOS group was longer than the other two groups [19 (14, 27) d vs. 15 (12, 20) d and 14 (12, 19) d] ( P<0.05). Conclusions:The clinical characteristics of neonatal sepsis vary among different types of infections, and it is necessary to establish appropriate prevention, control, diagnosis and treatment protocols.

Five new flavonoid derivatives, cajavolubones A-E (1-5), along with six known analogues (6-11) were isolated from Cajanus volubilis, and their structures were elucidated by spectroscopic analysis and quantum chemical calculations. Cajavolubones A and B (1 and 2) were identified as two geranylated chalcones. Cajavolubone C (3) was a prenylated flavone, while cajavolubones D and E (4 and 5) were two prenylated isoflavanones. Compounds 3, 8, 9 and 11 displayed cytotoxicity against HCT-116 cancer cell line.
Flavonoids/chemistry* ; Cajanus ; Molecular Structure ; Chalcones/chemistry*

Objective:To investigate the effects of aerobic combined stretching exercise during dialysis on the severity of restless legs syndrome(RLS), quality of life and sleep quality in hemodialysis (HD) patients.Methods:A total of 63 HD patients with RLS who were admitted to the Hemodialysis Center, Renmin Hospital of Wuhan University from March 2018 to March 2019 were selected as research objects. According to the random number table method, they were divided into the observation group (32 cases) and the control group (31 cases). Patients in the control group were given conventional nursing methods while patients in the observation group were given the aerobic combined stretching exercise during dialysis. The International Restless Legs Syndrome Rating Scale (IRLS) Kidney Disease Quality of Life, (KDQOL-36 TM), Pittsburgh Sleep Quality Index(PSQI) and blood chemistry were used to evaluate the effect of exercise on HD patients with RLS. Results:After intervention, the observation group ′s IRLS scores was 12.19±4.48, lower than the control group (17.87±3.91), the difference was statistically significant ( t value was 3.021, P<0.05). The scores of physical health, mental health, kidney burden, symptoms and discomfort, effects of kidney disease in KDQOL-36 TM of the observation group were 44.56±6.64, 46.12±4.95, 19.92±15.91, 87.59±5.65, 64.55±13.20, higher than the control group (37.43±4.81, 41.81±4.87,12.10±14.87, 78.83±7.96, 55.45±15.52), the differences were statistically significant ( t values were -5.027--2.015, P<0.05). The PSQI total score was 8.94±2.54, lower than that of the control group (13.13±1.31), the difference was statistically significant ( t value was 8.271, P<0.05). The blood phosphorus was (1.80±0.48) mmol/L in the observation group, lower than (2.04±0.34) mmol/L in the control group, and hemoglobin, blood calcium [(105.31±13.58) g/L, (2.26±0.20) mg/L] were higher than those in the control group[(99.52±8.21) g/L, (2.05±0.29) mg/L], the differences were statistically significant ( t values were 2.275, -2.042, -3.325, P<0.05). Conclusions:The aerobic combined stretching exercise during dialysis relieves the symptom of RLS, improves the sleeping quality and quality of life.

Pace of life and work of people is accelerating nowadays, and hospitals keep improving their services, which gives rise to the decoction and delivery service from the third party vendors for traditional Chinese medicine(TCM).Given the quality control standards for the TCM decoction service as issued by Zhejiang and other regions, the systems of supervision and assessment remain incomplete.Authors of the paper introduced a project improvement team, composed of Chinese medicine pharmacy, Chinese medicine experience specialists, vendors of Chinese medicine decoction and express delivery companies, hence establishing a " three-in-one" supervision system of Internet+TCM decoction and delivery service. This practice can optimize the assessment indexes, strengthen the assessment system of assessment transformation and supervision system for patient medication.It proves that the practice contributes to higher quality and safety of TCM decoction and delivery service, improves the ability and level of TCM services, and ensures the medication safety of patients.

Objective To study the correlation between characteristic parameters of photoplethysmography( PPG)and severity of coronary artery lesions.Methods Two hundred and twenty-six CHD patients who underwent CAG in our hospital from August 2018to November 2018were divided into single-vessel lesion group(n=55),double-vessel lesion group(n=74)and multi-vessel lesion group(n=97)according to their CAG.Their stiffness index(SI),crest time(CT),normalized crest time(NCT)and crest time ratio(CTR)were recorded by PPG and analyzed by correlation analysis.Results The SI was significantly different in single-vessel lesion group,double-vessel lesion group and multi-vessel lesion group(6.479±0.819m/s,6.692±1.051m/s and 6.943±1.096m/s,P=0.024).No significant difference was detected in CT,NCT and CTR among single-vessel lesion group,double-vessel lesion group and multi-vessel lesion group(P＞0.05).The SI was positively correlated with the severity of coronary artery lesions(r=0.162,P=0.015).Conclusion The SI is correlated with the severity of coronary artery lesions,which is of a certain value in predicting the severity of coronary artery lesions.

Objective To explore the value of minimally invasive puncturation via the hard tunnel in decompression before craniotomy for acute subdural hematoma combined with cerebral hernia.Methods A retrospective method was adopted to analyze the clinical data of 303 patients with traumatic acute subdural hematoma combined with cerebral hernia treated from January 2004 to October 2016.There were 206 males and 97 females,with age range of 12-77 years [(43.6 ± 20.1) years].The Glasgow coma scale (GCS) was 3-5 points in 187 patients and 6-8 points in 116.The patients were divided into study group (n =199) and control group (n =104) according to the different surgical procedures.For study group,the patients were treated with disposable ventricular needle to suck out and drain the intracranial hematoma,and the skull was opened through the large craniotomy to remove the subdural hematoma.For control group,the skull was opened through the large craniotomy which was used to directly remove the subdural hematoma according to the traditional instruction.The differences between two groups were compared with regard to time from confirming the cerebral hernia to the first decompression,time of regaining consciousness after surgery,hospitalization duration and cranial cavity infection after surgery.Glasgow outcome scale (GOS) was used to evaluate the prognosis.Results The time to first decompression was 10-15 minutes [(12.5 ± 1.7)minutes] in study group and 50-75 minutes [(133.0 ± 7.9) minutes] in control group (P ＜ 0.05).Regaining consciousness within 3 days after surgery was found in 62 patients of study group and 18 of control group.Regaining consciousness at days 4-7 after surgery was found in 76 patients of study group and 22 of control group.Regaining consciousness at days 8-15 days after surgery was found in 26 patients of study group and 29 of control group.Regaining consciousness over 15 days after surgery was found in 10 patients of study group and 12 of control group.Postoperative unconsciousness including death was found in 25 patients of study group and 23 of control group (P ＜ 0.05).The hospitalization duration was (19.5 ± 1.1) days in study group and (22.8 ± 2.8) days in control group (P ＜ 0.05).No cranial cavity infection was found in study group,while cranial cavity infection occurred in one patient in control group.According to the GOS,the outcome in study group was good in 133 patients,moderate to severe disability in 41,vegetative state in 7 and death in 18,while the outcome in control group was good in 34 patients,moderate to severe disability in 47,vegetative state in 9 and death in 14 (P ＜ 0.05).Conclusion The minimally invasive puncturation via the hard tunnel to remove the hematoma is capable of reducing the intracranial pressure before craniotomy for acute subdural hematoma combined with cerebral hernia,can decrease the disability rate and hence is prioritized to clinical application.