Bacteria have posed a threat to human health,and the emergence of super bacteria has made it more difficult to cure bacterial infections in clinical practice.Currently,vaccines are one of the effective means of preventing bacterial infections.With the rapid development of cutting-edge technologies in recent years in such disciplines as biology,medicine,and materials science,various innovative strategies have been provided for vaccine research and preparation.This article summarizes the status quo and prospects of innovative vaccines for treating bacterial infections in recent years,including subunit vaccines,mRNA vaccines and attenuated live vaccine in the hopes of providing data for subsequent development and research of bacterial vaccines.

Objective:To evaluate the short-term precision and accuracy of bone mineral density (BMD) measured with quantitative CT (QCT) and dual-energy X-ray absorptiometry (DXA) in multi-centre clinical research with a European spine phantom (ESP).Methods:From January 2016 to April 2020, totally 40 CT scanners (12 Siemens from Germany, 12 Philips from Netherlands, 9 GE from US, 5 Toshiba from Japan, 2 United Imaging from China) and 53 DXA instruments (34 GE Lunar from US, 14 Hologic from US, 5 Medlink from France) used in multi-centre in China were enrolled. The CT equipment came from 31 centers and DXA equipment from 32 centers.Using Mindways QCT software, the ESP was scanned 10 times on each instrument with repositioning using standardized spine protocols with QCT and DXA. The BMD value of the three lumbar vertebrae with low, medium, high density and the mean BMD value were measured. Accuracy was assessed by comparing BMD values measured on each device with the actual value of the phantom. Short-term precision was calculated as the root-mean-square standard deviation (RMS-SD) and root-mean-square standard deviation coefficient of variation (RMS-%CV) for the repeated measurements. The repeated measures variance analysis was used to compare the differences in BMD between different devices.Results:The differences in BMD values were statistically significant among different CT and DXA devices.The ranges of the accuracy measured by different QCT devices were 1.20% to 7.60% for Siemens, -1.83% to 0.20% for Philips, 1.18% to 13.20% for GE, -0.12% to 3.55% for Toshiba, -1.65% to 6.32% for United Imaging, 6.59% to 21.34% for GE Lunar, -6.65% to 5.45% for Hologic, and -6.97% to -0.68% for Medlink, respectively. The RMS-%CV of all vertebral BMD values measured by QCT and DXA ranged from 0.38% to 3.85%. The RMS-SD of QCT was 0.54 to 2.45 mg/cm 3, of DXA was 0.009 to 0.037 g/cm 2. The RMS-%CV values of each vertebral body measured by different QCT and DXA devices decreased with the increase of BMD, while the RMS-SD values showed the opposite tendency. Conclusions:Based on ESP, the QCT and DXA devices have significant differences in lumbar spine BMD measurement. Comparing the measurement results among different devices requires cross-calibration. Overall, the accuracy and short-term precision are within a reasonable range, which can be used for clinical follow-up observation. The short-term precision error and accuracy error range of QCT in evaluating the density of ESP were slightly smaller than those of DXA.

This review summarizes the basic situation and characteristics of nuclear technology utilization and radiation safety supervision in Sichuan Province, analyzed the main problems of radiation safety supervision, put forward the corresponding countermeasures and suggestions, and provided reference for improving the radiation safety supervision ability of the whole province.

Objective:To investigate the relationship between the expression of hepatocyte nuclear factor-1 α (HNF-1α) and the occurrence and development of liver inflammation and fibrosis in liver tissues of patients with chronic hepatitis B.Methods:Sixty-four patients with chronic hepatitis B who were diagnosed and treated in our hospital from 2011 to 2018 were selected. All patients underwent ultrasound-guided aspiration liver biopsy. The pathological results of liver biopsy were collected for inflammation grading and fibrosis staging. The liver puncture biopsies was collected by paraffin sectioning. The expression of HNF1α in the liver tissue was detected by immunohistochemical staining. Mantel-Haenszel χ2 test was used for bidirectional ordered grouping data, and Spearman’s rank-correlation test was used for rank correlation analysis. Results:There were varying degrees of inflammatory necrosis and fibrosis in the liver tissues of patients with chronic hepatitis B. There was a linear relationship between the expression of HNF1α and the level of inflammation in liver tissues ( χ2MH = 40.70, P < 0.05). The expression of HNF1α in liver tissues of patients with chronic hepatitis B was decreased with the increase of liver inflammation. The expression intensity of HNF1α was negatively correlated with the inflammation grade ( rs = -0.815, P < 0.05). There was a linear relationship between the expressions of HNF1α and the degree and stage of liver fibrosis ( χ2MH = 31.95, P < 0.05). The expression level of HNF1α in liver tissue was gradually decreased with the aggravation of liver fibrosis. The expression intensity of HNF1α was negatively correlated with fibrosis stage ( rs = -0.713, P < 0.05). Conclusion:HNF1α is closely related to the occurrence and development of liver tissue inflammation and fibrosis, and is expected to be a sensitive indicator for evaluating the level of liver tissue inflammation and fibrosis in patients with chronic hepatitis B. In addition, its down-regulation may be involved in the process of occurrence and development of liver inflammation and liver fibrosis, and may become a new target for the treatment of chronic hepatitis B.

Liver fibrosis is a chronic liver injury caused by various etiologies and a complex pathological change with the activation of hepatic stellate cells as the central link, and various signaling pathways are involved in the regulation of such complex lesions. It has the dual nature of repair and damage and may eventually progress to liver cirrhosis, liver failure, and even liver cancer. In recent years, rapid progress has been made in the basic research on the cell signal transduction pathways associated with liver fibrosis, and some achievements have been made in the research on the treatment strategy of liver fibrosis. This article briefly reviews the cell signaling pathways associated with the development of liver fibrosis, including the JAK/STAT signaling pathway, the NF-κB signaling pathway, the MAPK signaling pathway, the TGF-signaling 1/Smad signaling pathway, the Wnt signaling pathway, the Hedgehog signaling pathway, and the Notch signaling pathway, and also introduces the potential therapeutic strategies for liver fibrosis at present.

Objective To establish a comprehensive method combining physical model experiment and numerical simulation for studying airflow state of upper respiratory tract. Methods Based on CT medical images published online, a three-dimensional (3D) model of human upper respiratory tract was reconstructed. Based on 3D printing technology, an experimental model of the upper respiratory tract was established and the flow process of respiration was measured. A numerical simulation model was created based on the meshing of upper respiratory tract model and the turbulent Realizable k-ε model. Results Firstly, the result of numerical simulation was compared with the experimental conditions, and good agreement was achieved. The numerical simulation results showed that the airflow in respiratory process was in a parabolic shape; the distribution of flow field, pressure on wall and vortex structure were different between inspiratory and expiratory phases; there were air residues in the upper and lower nasal passages during the respiratory exchange process. In addition, the effects of airflow on physiological environment of the upper respiratory tract were preliminarily analyzed through the steak line, pressure field and vortex structure distribution. Conclusions The method proposed in this paper has the characteristics of pertinence, rapidity and accuracy, which gives full play to the advantages of reliable physical experiments and fine numerical simulation, and is applicable for studying different problems of the upper respiratory tract in different cases, with a high value for personalized diagnosis and treatment in clinic.

Objective:To investigate the deep venous thrombosis (DVT) cognition and its influencing factors in patients with lower extremity DVT first time diagnosed so as to provide a basis for DVT management.Methods:From December 2018 to September 2019, we selected patients with lower extremity DVT first time diagnosed at Peking Union Medical College Hospital by convenience sampling. The cross-sectional investigation was carried out with the self-designed questionnaire including the general information, disease data, DVT knowledge. This study analyzed the influencing factors of DVT cognition of patients.Results:A total of 100 questionnaires were sent out and 99 valid questionnaires were collected. The standardized score of DVT knowledge was (45.76±28.05) . Single factor analysis showed that there were statistical differences in the scores of DVT knowledge among patients with different ages, education levels, types of thrombosis, diagnosis time of DVT, swelling, affecting life and work, awareness of intervention ( P<0.05) . Multiple linear regression analysis showed that the influencing factors of disease cognition of patients with lower extremity DVT first time diagnosed including the education levels and awareness of intervention with statistical differences ( P<0.05) . Conclusions:Patients with DVT first time diagnosed have the low level of disease cognition. Nurses should provide individualized health education and guide based on patients' personal and disease characteristics to improve patients' cognition on DVT, and DVT prevention to improve patients' long-term prognosis.

Objective:To explore the application effect of family-centered health education on parents of patients with adolescent idiopathic scoliosis.Methods:From September 2015 to December 2018, parents of patients who were diagnosed with adolescent idiopathic scoliosis in the Department of Orthopedics of a Class Ⅲ Grade A hospital in Beijing were selected as the research objects by convenience sampling method. According to the order of admission time, they were divided into the control group with 71 cases and the observation group with 67 cases. Parents in the control group were given routine health education while parents in the observation group were given family-centered health education on basis of the control group. The Chinese version of the State-Trait Anxiety Inventory and the Family Management Measure Scale were used to assess anxiety status and disease management abilities of parents, respectively.Results:There was no statistically significant difference in anxiety level of parents between the two groups ( P> 0.05) . At 3 and 6 months after discharge, the scores of parental disease management ability in the observation group were (45.89±4.18) and (41.84±3.02) , which were higher than (42.43±5.28) and (40.25±4.20) in the control group. The differences were statistically significant ( P<0.05) . The scores of parental disease management difficulties in the observation group were (28.20±4.71) and (32.98±6.16) , which were lower than (33.75±6.42) and (36.97±5.60) of the control group. The differences were statistically significant ( P<0.05) . Conclusions:Family-centered health education can improve parental disease management abilities of patients with adolescent idiopathic scoliosis after discharge, which is worthy of clinical reference and application.

Objective:To explore the effects of family-centered educational intervention on disease cognition and quality of life in patients undergoing surgery for adolescent idiopathic scoliosis (AIS) .Methods:A total of 122 patients diagnosed with AIS at the Ward Department of Orthopedics in a ClassⅢ Garde A hospital in Beijing from September 2015 to December 2018 were selected by convenient sampling, and divided into the control group ( n=62) and the observation group ( n=60) according to the admission time. Patients in the control group received routine health education, while patients in the observation group received family-centered educational intervention on this basis. The self-designed disease knowledge questionnaire and the Chinese version of Scoliosis Research Society Outcomes Questionnaire (SRS-22) were used to evaluate the disease knowledge and quality of life in the two groups of patients upon admission, 3 months and 6 months after discharge. Results:There was no statistically significant difference in the scores of disease knowledge between the two groups upon admission, 3 months and 6 months after discharge ( P>0.05) . Repeated measures analysis of variance showed no statistically significant difference in the interaction effect and between-group effect of the two groups' scores at 3 the time points ( P>0.05) , whereas the difference in the time effect was statistically significant ( P<0.05) . Three months after discharge, the total score of SRS-22 in the control group was (4.14±0.36) , while that in the observation group was (4.32±0.30) , and the difference was statistically significant ( t=2.964; P<0.05) . Conclusions:Family-centered educational intervention can appropriately improve the quality of life in patients with AIS and help them recover from illness.

Objective To investigate the prevalence and endoscopic detection rate of proximal serrated polyps and to screen the risk factors. Methods The data of 9010 colonoscopies performed by 22 endoscopists between September 2016 and September 2017 were reviewed. The adenoma detection rate (ADR) and proximal serrated polyp detection rate (PSDR) were calculated, and the correlation between ADR and PSDR was estimated by Pearson correlation coefficients. Multivariate logistic regression was used to analyze PSDR among endoscopists. Results For all subjects, the mean ADR was 30. 07％ ( ranged from 20. 00％ to 40. 78％) and mean PSDR was 4. 70％ ( ranged from 1. 52％ to 9. 28％) . PSDR of males was 1. 38 times of that of females ( OR=1. 38, 95％CI:1. 13-1. 69, P<0. 01) . For 3560 cases ( 39. 51％) of 50 years and older subjects, the mean ADR was 45. 01％ ( 28. 99％-57. 78％) and mean PSDR was 6. 08％(2. 07％-10. 56％). PSDR was moderately correlated with ADR (r=0. 48, P=0. 02). PSDR of males was 1. 36 times of that of females (OR=1. 36, 95％CI: 1. 04-1. 80, P=0. 03). Endoscopist was a significant risk factor for detection of proximal serrated polyps ( P<0. 01) . Compared with endoscopist with the highest PSDR, odds ratio of other endoscopists ranged from 0. 16 (95％CI:0. 06-0. 40, P<0. 01) to 0. 83 (95％CI:0. 53-1. 32, P=0. 44) . Conclusion Proximal serrated polyps are more common in males, who are over 50 years old. The PSDR is highly variable and dependent on endoscopists. It is possible that a certain proportion of proximal serrated polyps are missed during colonoscopy.