Objective:To study the complete genome characterization of Human Astrovirus (HAstV) in Shandong Province.Methods:Stool samples from acute flaccid paralysis (AFP) surveillance in Shandong Province from 2020 to 2022 were collected, and HAstV nucleic acid was examined by real-time quantitative PCR (qPCR). Next-generation sequencing (NGS) was conducted for the positive samples to obtain complete genome sequences and identify the genotype. Homology comparison and phylogenetic analysis were performed by using BioEdit and Mega software.Results:A total of 667 samples were examined by qPCR, of which 14 were HAstV-positive (2.1%), including HAstV-1 ( n=6), MLB1 ( n=6), MLB2 ( n=1), and VA2 ( n=1). The complete genome sequences were obtained from 11 samples. The six HAstV-1 sequences of this study had 98.2% to 99.9% nt similarities with each other and 87.6% to 98.6% with those from other regions. The four MLB1 sequences of this study had 99.1% to 99.9% nt similarities with each other and 92.2% to 99.4% with those from other regions. The VA2 sequence of this study had 96.0% to 96.3% nt similarities with those from other regions. Phylogenetic analysis based on ORF2 region showed that the local HAstV-1 sequences were most closely related to Japanese strains, and had distinct topology with phylogenies based on ORF1a and ORF1b regions. Conclusion:The complete genome sequences of 11 HAstV strains are obtained, and the VA2 complete genome is found.

Objective:To understand the dilemma of active management in young and middle-aged postoperative patients with lumbar disc herniation, in order to provide reference for the formulation of active intervention program of self-health management meeting the needs of patients.Methods:Using the phenomenological research method, a total of 16 middle-aged and young patients with lumbar disc herniation were selected for semi-structured in-depth interviews, and the themes were analyzed and extracted by Colaizzi 7-step analysis method.Results:Three themes and nine sub-themes were extracted namely, inadequate disease response capacity and response resources (lack of disease symptom management capacity, limited access to disease management information, difficult use of disease management information, difficulty in maintaining positive self-management for a long time (forced to stop behavior change due to stress, lack of motivation to achieve good behavior change, doubts about the effectiveness of self-management) and multi-dimensional negative emotions (contrast between maintaining independence and dependence on others, fear of being misunderstood, fear of relapse) .Conclusions:Medical staff should provide comprehensive health information services for young and middle-aged postoperative patients with lumbar disc herniation, improve the out-of-hospital follow-up mechanism with the help of information technology, further improve family and social support strategies, reduce the difficulties faced in the process of active management and achieve long-term active disease management.

Objective:To explore the quality of working life and its related factors in patients with breast canc-er returned to work after surgery.Methods:A total of 316 patients with breast cancer who had returned to work af-ter surgery were selected,and they were investigated with the General information questionnaire,Quality of Working Life Questionnaire for Cancer Survivors(QWLQ-CS),Breast Cancer Survivors Resilience Scale(BCRS)and Strat-egies Used by People to Promote Health(SUPPH).Multivariate linear regression analysis was used to analyze the related factors of quality of working life.Results:Multiple linear regression analysis showed that the QWLQ-CS score was positively correlated with education level,per capita monthly income of family,work pattern,return to work time,personal protection and social protection score of BCRS,and positive attitude scores of SUPPH(β=1.05,1.23,2.26,0.69,0.95,1.00,0.13),while negatively correlated with the complications(β=-3.83).Con-clusion:The quality of working life for patients with breast cancer after surgery needs to be improved after they re-turn to work,psychological resilience and self-efficacy are positively correlated with quality of working life.

Objective:To evaluate the predictive value of age-adjusted Charlson comorbidity index (ACCI) for in-hospital mortality and 1-year mortality in patients with acute type A aortic dissection (ATAAD).Methods:This was a retrospective cohort study, and the clinical data of ATAAD patients admitted to Wuhan Union Hospital from January 1, 1999 to December 31, 2018 were collected for analysis. All the patients were confirmed by computed tomography angiography or magnetic resonance imaging of the aorta and the onset time was less than 14 days. Patients who survived at discharge were followed up to obtain 1-year survival information. The ACCI score was calculated for patients based on their comorbidities and age at admission, and they were divided into three groups of 0, 1 and ≥2 according to the ACCI score. The in-hospital mortality and 1-year mortality of the three groups were compared. Logistic regression analysis was applied to determine the independent predictors for in-hospital mortality and 1-year mortality.Results:Among 1 133 ATAAD patients, 383, 357 and 393 patients had ACCI score of 0, 1, and ≥2, respectively. The in-hospital mortality and 1-year mortality of patients with ACCI score ≥2 were significantly higher than those of patients with ACCI score of 0 (25.4% vs. 17.0%, 30.0% vs. 19.6%, both P<0.05). Multivariate Logistic regression analysis showed that ACCI score ≥2 was an independent risk factor for in-hospital mortality ( OR=1.670, 95% CI: 1.176-2.370, P=0.004) and 1-year mortality ( OR=1.762, 95% CI: 1.264-2.456, P<0.001). Age (per 10-year increase) and cerebrovascular diseases were independent risk factors for in-hospital mortality and 1-year mortality, while diabetes mellitus was a protective factor for in-hospital mortality. Conclusions:ACCI can predict the in-hospital mortality and 1-year mortality of ATAAD patients, and patients with ACCI score ≥2 have a poorer prognosis.

Objective:To investigate the immune reconstitution and its influencing factors in HIV/AIDS patients with antiretroviral therapy in Ningbo.Methods:The data were collected from HIV/AIDS patients of HIV/AIDS Comprehensive Response Information System in Ningbo during 2010-2020. The inclusion criteria of study subjects were HIV/AIDS patients aged 15 or above at initiation of antiretroviral therapy with duration of more than one year follow-up and baseline CD4 +T lymphocyte (CD4) counts completed. A retrospective cohort study was conducted to describe the epidemiological characteristics of the subjects, and univariate and multivariate Cox proportional risk regression models were used to analyze the influencing factors of immune reconstitution in HIV/AIDS patients. Results:A total of 3 851 HIV/AIDS patients were enrolled, in whom 3 185 were males (82.71%,3 185/3 851), 3 769 were in Han ethnic group (97.87%,3 769/3 851), and 1 333 had education level of junior high school (34.62%). Of the subjects, the age at initiation of antiretroviral therapy was (39.47±13.47) years. The median ( Q1, Q3) of follow-up time was 47 (25,77) months. The immune reconstitution after antiretroviral therapy accounted for 66.22% (2 550/3 851) in HIV/AIDS patients. Multivariate Cox proportional risk regression model results showed that, compared with HIV/AIDS patients receiving initial antiretroviral therapy at age ≥45 years, having baseline BMI <23.0 kg/m 2 and baseline CD4 counts <200 cells/μl, receiving initial antiretroviral therapy regimen of zidovudine+lamivudine+nevirapine (AZT+3TC+NVP), the immune reconstitution was more likely to occur in HIV/AIDS cases receiving initial antiretroviral therapy at age <30 years,having baseline BMI ≥23.0 kg/m 2 and baseline CD4 counts ≥200 cells/μl, receiving initial antiretroviral therapy regimen of AZT+3TC+efavirenz (EFV). Conclusions:Age at initial antiretroviral therapy, baseline BMI, baseline CD4 counts and initial regimens were the main factors affecting immune reconstitution. Therefore, it is necessary to start antiretroviral therapy as early as possible, conduct regular follow up and monitor CD4 levels, and pay attention to HIV/AIDS patients with older age and lower baseline BMI.

Objective : To investigate the factors of hyperglycemia among HIV/AIDS patients receiving antiretroviral therapy (ART) in Ningbo City. Methods : The demographic characteristics, ART and fasting blood glucose were collected from HIV/AIDS patients receiving ART in Ningbo City from 2005 to 2021 through the Ningbo Municipal ART Database. The fasting blood glucose levels were analyzed among HIV/AIDS patients receiving ART, and the factors affecting hyperglycemia were identified using a multivariable logistic regression model. Results : A total of 2 607 HIV/AIDS patients were enrolled, including 2 162 men (82.93%), and the participants had a mean age of (45.16±13.93) years, and had mean ART duration of 5.00 years (interquartile range, 5.00 years). The prevalence of hyperglycemia, impaired fasting glucose and diabetes was 22.59%, 13.62% and 8.98%, respectively. Multivariable logistic regression analysis showed that gender (male, OR=1.482, 95%CI: 1.120-1.961), age (30 years-, OR=2.062, 95%CI: 1.356-3.137; 45 years-, OR=3.697, 95%CI: 2.435-5.611; 60 years and older, OR=7.295, 95%CI: 4.722-11.268), WHO clinical staging of HIV diseases (stage Ⅱ, OR=1.415, 95%CI: 1.097-1.824; stage Ⅲ, OR=1.571, 95%CI: 1.139-2.168; stage Ⅳ, OR=1.488, 95%CI: 1.040-2.128, duration of HIV infections (7 to <10 years, OR=1.336, 95%CI: 1.004-1.777), treatment regimen (second-line regimen, OR=0.611, 95%CI: 0.472-0.792), and blood lipids (high TG, OR=1.665, 95%CI: 1.307-2.123; high TC, OR=1.415, 95%CI: 1.006-1.991; dyslipidemia, OR=2.597, 95%CI: 1.971-3.422) significantly correlated with hyperglycemia. Conclusions The overall prevalence of hyperglycemia was 22.59% among HIV/AIDS patients with ART in Ningbo City, and the prevalence of hyperglycemia correlated with gender, age, clinical staging of HIV infections, duration of HIV infections, treatment regimens and blood lipids among HIV/AIDS patients.

Objective:To illustrate the effectiveness of Micro-Teachermate platform combined with problem-based learning (PBL) in gynecology and obstetrics teaching.Methods:Students from different classes were randomly divided into experimental group and control group, and the general data of the two groups were compared. The two groups respectively adopted Micro-Teachermate platform combined with PBL and traditional lecture teaching methods. The class attendance rate and the scores of relevant chapters in the final examination were analyzed through statistical methods for assessing the enthusiasm of students and teaching quality in class in terms of the same content and the same class hours. A questionnaire survey was conducted to know students' evaluation of this teaching mode, evaluating its teaching effect and satisfaction comprehensively. SPSS 17.0 was used for t test and chi-square test. Results:There was no difference in general information between the two groups. The class attendance rate of the experimental group (274/279) was significantly higher than that of the control group (61/90), while the scores of the relevant chapters in the final exam were also significantly higher ( P<0.01). Questionnaire survey results among 93 students in the experimental group were taken back 93 valid questionnaires (the effective rate, 100%), showing that most of the students were very satisfied with this teaching mode (90/93) and hoped to apply it to more subjects teaching (89/93). Conclusion:The application of Micro-Teachermate platform combined with PBL in gynecology and obstetrics class teaching contributes to improve students' participating enthusiasm and can effectively improve the quality and efficiency of teaching. Most students highly recognize the teaching method, which is worth applying and popularizing.

Objective:To illustrate the effectiveness of Teachermate platform combined with problem-based learning (PBL) in gynecology and obstetrics teaching.Methods:Students from different classes were randomly divided into experimental group and control group, and the general data of the two groups were compared. The two groups respectively adopted Teachermate platform combined with PBL and traditional lecture teaching methods. The class attendance rate and the scores of relevant chapters in the final examination were analyzed through statistical methods for assessing the enthusiasm of students and teaching quality in class in terms of the same content and the same class hours. A questionnaire survey was conducted to know students' evaluation of this teaching mode, evaluating its teaching effect and satisfaction comprehensively.Results:There was no difference in general information between the two groups. The class attendance rate of the experimental group (274/279) was significantly higher than that of the control group (61/90) ( P=0.00), while the scores of the relevant chapters in the final exam were also significantly higher ( P=0.00). Questionnaire survey results among 93 students in the experimental group were taken back 93 valid questionnaires (the effective rate, 100%), showing that most of the students were very satisfied with this teaching mode (90/93) and hoped to apply it to more subjects teaching (89/93). Conclusion:The application of Teachermate platform combined with PBL in gynecology and obstetrics class teaching contributes to improve students' participating enthusiasm and can effectively improve the quality and efficiency of teaching. Most students highly recognize the teaching method, which is worth applying and popularizing.

Objective: To investigate the changes of C-reactive protein(CRP), fibrinogen(FIB) and erythrocyte sedimentation rate(ESR) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS), and their relationship with sleep respiratory parameters. Methods: From June 2015 to August 2018, 70 OSAHS patients[observation group, apnea hypopnea index(AHI)≥5/h]and 20 persons in the snoring control group(control group, AHI<5/h) who received the monitor of polysomnography in the Pingxiang People′s Hospital were enrolled.The levels of CRP, FIB and ESR were measured and compared between the two groups.The correlations were analyzed between the levels of inflammatory markers and sleep breathing parameters. Results: The two groups had no statistically significant differences in age, gender and BMI(all P>0.05). The CRP, FIB and ESR of the observation group were (4.5±3.0)mg/L, (3.3±0.9)g/L, (11.4±5.4)mm/h, respectively, which were significantly higher than those of the control group[(2.0±1.5)mg/L, (2.9±0.5)g/L, (7.6±2.6)mm/h](t=5.12, 2.68, 4.36, all P<0.05). The level of CRP was positively correlated with AHI, oxygen desaturation index(ODI)(r=0.285, P<0.05 and r=0.282, P<0.05), and negatively correlated with the lowest SaO₂ and the average SaO₂(r=-0.257, P<0.05 and r=-0.259, P<0.05). The level of FIB was positively correlated with AHI, ODI(r=0.430, P<0.01 and r=0.311, P<0.01), and negatively correlated with the lowest SaO₂(r=-0.287, P<0.01). There were no correlations between ESR and sleep breathing parameters. Conclusion The levels of CRP, FIB and ESR are increased in OSAHS patients, and the levels of CRP and FIB are proportional to the severity of OSAHS, suggesting that OSAHS patients has systemic inflammatory response.

In order to improve the brain distribution of fibroblast growth factor 21(FGF21), TAT-FGF21 fusion protein was designed and its neuroprotective activity was investigated. The recombinant plasmid of pET28a-TAT-FGF21 was constructed and transformed into E. coli BL-21(DE3)sensitive bacteria. The TAT-FGF21 fusion protein was purified by Ni-NTA affinity chromatography column after IPTG induced expression. The SH-SY5Y cell damage model was induced by Aβ25-35, and the TAT-FGF21 fusion protein was used to intervene. The effects of Aβ25-35 and TAT-FGF21 induced on SH-SY5Y cell viability were determined using MTT method; DCFH-DA fluorescent probe was used to detect the intervention effect TAT-FGF21 on reactive oxygen species(ROS)generation induced by Aβ25-35 in SH-SY5Y cells; the effects of Aβ25-35 and TAT-FGF21 on mitochondrial membrane potential in SH-SY5Y cells were detected with JC-1 fluorescent probe. The results showed that TAT-FGF21 could improve the viability of SH-SY5Y cells, reduce the intracellular ROS production level of SH-SY5Y cells, and enhance the mitochondrial membrane potential of SH-SY5Y cells, which indicate that TAT-FGF21 could protect neurons on SH-SY5Y cell injury induced by Aβ25-35 through alleviating oxidative damage.