BACKGROUND:Nanocomposite hydrogel has great research prospects and application potential in the treatment of osteoarthritis. OBJECTIVE:To review the research progress of nanocomposite hydrogel in osteoarthritis and cartilage repair. METHODS:Databases such as CNKI and PubMed were searched.The English key words were"nanocomposite hydrogel,nanogel,osteoarthritis,cartage,physical encapsulation,electrostatic interaction,covalent crosslinking",and the Chinese key words were"nanocomposite hydrogel,nanogel,osteoarthritis,cartage,physical encapsulation,physical encapsulation,electrostatic effect,covalent cross-linking".After an initial screening of all articles based on inclusion and exclusion criteria,71 articles with high correlation were retained for review. RESULTS AND CONCLUSION:In cell or animal experiments,nanocomposite hydrogel has the effect of improving osteoarthritis.Nanocomposite hydrogel can promote cartilage repair,improve the internal environment of osteoarthritis,and achieve the therapeutic purpose of osteoarthritis by improving the mechanical environment between joints,carrying targeted drugs,and promoting the chondrogenesis of seed cells.At present,the research of nanocomposite hydrogel in osteoarthritis disease still has a huge space to play.It is expected to open up a new way for the clinical treatment of osteoarthritis by continuing to deepen the research of material preparation and actively carrying out cell and animal experiments.

The aim of the present study was to investigate the effects of exosomes derived from bone marrow mesenchymal stem cells (BMSCs) on the polarization of M1/M2 microglia/macrophages in rats with acute cerebral ischemia.Ultrahigh-speed centrifugation was employed to isolate and identify exosomes; a middle cerebral artery occlusion (MCAO) model was prepared in rats using the intraluminal filament technique; Longa scoring and corner tests were used to evaluate the neurological function of rats; 2, 3, 5-triphenyltetrazole chloride (TTC) staining was used to assess the infarct volume in rat brains; immunofluorescence double-labeling of CD16/32/Iba1 and CD206/Iba1 was performed to detect M1/M2 phenotypes of microglia/macrophages; RT-qPCR was employed to measure the mRNA expression of CD86, inducible nitric oxide synthase (iNOS), tumor necrosis factor-alpha (TNF-α), arginase-1 (Arg-1), interleukin-10 (IL-10), and transforming growth factor beta (TGF-β) in the ischemic penumbra of rat brains.The experimental results showed that BMSC-Exos reduced the number of CD16/32+/Iba1+ positive cells in the ischemic penumbra (P < 0.01) while increasing the number of CD206+/Iba1+positive cells (P < 0.01), and decreased the mRNA expression of iNOS, CD86, and TNF-α, while increasing the mRNA expression of Arg-1, TGF-β, and IL-10 (P < 0.05 or P < 0.01).This research suggests that BMSC-Exos can regulate M1/M2 polarization of microglia/macrophages in rats with acute cerebral ischemia, alleviate neuroinflammation, and improve ischemic brain injury.

Objective:To construct an evaluation index system for comprehensive budget management at public hospitals and conduct empirical research for reference in evaluation of comprehensive budget management at public hospitals.Methods:From May to June 2022, based on the Implementation Measures for the Comprehensive Budget Management System of Public Hospitals and its interpretations, literature analysis, and expert interviews, a preliminary evaluation index system was developed for comprehensive budget management of public hospitals. Then the Delphi method was applied for two rounds of expert consultation, with experts invited to evaluate the importance of indexes, while the analytic hierarchy process was used to calculate the weight values of indexes. Based on such a comprehensive budget management evaluation index system, a questionnaire was developed, and tertiary public hospitals were selected based on the principle of convenient sampling. Then a questionnaire survey was conducted from June to October 2022. The questionnaire was filled out by hospital level leaders(chief accountants), finance/audit leaders, and directors of finance/audit/operation management departments from the sample hospitals with professional knowledge and rich operational management experience in budget management. The comprehensive budget management level of the sample hospital was thus evaluated based on the survey results. Results:The comprehensive budget management evaluation index system for public hospitals was composed of 2 first-level indexes, 4 second-level indexes, and 20 third-level ones. The weights for the 2 first-level indexes of target building and management orientation were both 0.500, while the weights for the 4 second-level indexes, namely strategic implementation, comprehensive coverage, performance evaluation, and adaptation matching were all 0.250. Among the third-level indexes, the weights of budget execution, system improvement, system establishment, organizational construction, and revenue and expenditure business ranked top five, with weights of 0.070, 0.069, 0.066, 0.066, and 0.064, respectively. A total of 95 hospitals were selected for questionnaire survey, and the evaluation found 46 of them with a comprehensive budget management level of " excellent" and " good" , 27 with a " moderate" level, and 22 with a " poor" and " very poor" level. Scores of the third-level indexes were between 39-94 points, while the score of 6 third-level indexes were below 60 points, namely interconnection, budget analysis, compatibility and adaptation, system improvement, participation level, and assessment application.Conclusions:The evaluation index system for comprehensive budget management at public hospitals in this study proves rational and practical, serving as a reference for the evaluation of comprehensive budget management at public hospitals and related researches.

Porcine reproductive and respiratory syndrome (PRRS) is a highly contagious disease caused by porcine reproductive and respiratory syndrome virus (PRRSV), which causes great economic losses. At the moment, no effective neutralizing antibody is available for scientific research and treatment. Therefore, developing a method for screening the neutralizing monoclonal antibodies is of great significance for the prevention and treatment of PRRSV and the screening of antigen sites. Monoclonal antibodies have been widely used in the treatment and diagnosis of many human and animal diseases. Therefore, screening effective neutralizing antibodies for different pathogens is an urgent task. Among the methods for monoclonal antibody screening, B cell immortalization is an effective method to obtain neutralizing monoclonal antibody. Specifically, in this study, the bcl-6 and bcl-xl genes were connected by f2a and then the yielded product was ligated to a vector for retrovirus packaging. The swine lymphocytes immunized with PRRSV were infected the yielded mature viruses and cultured in the complete medium containing CD40L and IL21 cytokines. Then, CD21 was used as the marker to screen B cells with the magnetic bead method. Finally, monoclonal B cells were obtained and the secretion of antibodies was tested. The results showed that the plasmid, either being transfected alone or with the packaged plasmids, could be expressed, and that the packaged retrovirus could infect the cells. Moreover, the infected lymphocytes secreted antibodies, so did the screened B cells. Therefore, the method for screening monoclonal antibody against PRRSV was successfully established.
Animals ; Antibodies, Monoclonal ; Antibodies, Neutralizing ; Antibodies, Viral ; Humans ; Porcine Reproductive and Respiratory Syndrome/prevention & control* ; Porcine respiratory and reproductive syndrome virus/genetics* ; Swine

Objective:To investigate the current status of knowledge, attitude and practice of palliative care among nurses in 10 general hospitals in Beijing and explore its influencing factors, so as to provide a reference for further training and management of palliative care.Methods:From March to April 2020, convenience sampling was used to select nurses from 10 general hospitals in Beijing for investigation with three questionnaires on knowledge, attitude and behavior of palliative care in Chinese. A total of 850 questionnaires were returned and 833 valid questionnaires were collected, with a valid rate of 98.00%. Multiple linear regression analysis was used to analyze the influencing factors of knowledge, attitude and behavior of palliative care among nurses.Results:The overall score for palliative care of nursing staff in 10 general hospitals in Beijing was (82.16±8.73) , with a score rate of 68.47%. The knowledge score was (12.36±4.14) with a score rate of 61.80%, and the attitude score was (36.85±3.97) with a score rate of 61.42%, and the behavior score was (32.95±5.84) with a score rate of 82.37%. Multiple linear regression analysis showed that participation in palliative care training, gender, job title, knowledge and attitude, and monthly income were the main influencing factors of nurses' knowledge, attitude and behavior on palliative care ( P<0.05) . Conclusions:The current status of palliative care awareness among nurses in Beijing general hospitals is at an intermediate level and needs to be further improved. Nursing managers should strengthen the training and education of nursing staff, improve relevant knowledge, palliative care attitudes and professional enthusiasm, so as to promote behavioral changes and improve the quality of clinical nursing.

Antigenic purity is important for quality control of the foot-and-mouth (FMD) whole virus inactivated vaccine. The recommended method for evaluation the antigenic purity of FMD vaccine is to check the serum conversion to non-structural protein (NSP) 3AB antibody after 2 to 3 times inoculation of animals with inactivated vaccine. In this study, we developed a quantitative ELISA to detect the amount of residual 3AB in vaccine antigen, to provide a reference to evaluate the antigenic purity of FMD vaccine. Monoclonal antibody (Mab) of NSP 3A and HRP-conjugated Mab of NSP 3B were used to establish a sandwich ELISA to quantify the NSP 3AB in vaccine antigen of FMD. Purified NSP 3AB expressed in Escherichia coli was serially diluted and detected to draw the standard curve. The detectable limit was determined to be the lowest concentration of standard where the ratio of its OD value to OD blank well was not less than 2.0. Results: The OD value was linearly corelated with the concentration of 3AB protein within the range between 4.7 and 600 ng/mL. The correlation coefficient R² is greater than 0.99, and the lowest detectable limit is 4.7 ng/mL. The amount of 3AB protein in non-purified inactivated virus antigen was detected between 9.3 and 200 ng/mL depending on the 12 different virus strains, whereas the amount of 3AB in purified virus antigen was below the lowest detectable limit. The amount of 3AB in 9 batches of commercial FMD vaccine antigens was between 9.0 and 74 ng/mL, whereas it was below the detectable limit in other 24 batches of commercial vaccine antigens. Conclusion: the sandwich ELISA established in this study is specific and sensitive to detect the content of 3AB protein in vaccine antigen of FMD, which will be a useful method for evaluation of the antigenic purity and quality control of FMD inactivated vaccine.
Animals ; Antibodies, Viral ; Enzyme-Linked Immunosorbent Assay ; Foot-and-Mouth Disease/prevention & control* ; Foot-and-Mouth Disease Virus ; Viral Nonstructural Proteins/genetics* ; Viral Vaccines

Objective:To analyze the changes of total gray matter volume in patients with subcortical vascular cognitive impairment (SVCI) and their correlation with cognitive impairment.Methods:Data of fifty patients with subcortical ischemic vascular disease (SIVD) who admitted to the outpatient department or ward of the Department of Neurology, the First Affiliated Hospital of Anhui Medical University from November 2017 to March 2019, were collected for the study, including 23 patients with SVCI and 27 patients with subcortical ischemic vascular disease without cognitive impairment (SIVD-NCI). All subjects were assessed using the Minimal Mental State Examination (MMSE), the Montreal Cognitive Assessment scale (MoCA), the Cambridge Cognitive Assessment scale for the elderly-Chinese version (CAMCOG-C), the Stroop test, the Geriatric Depression Scale, and the Activity of Daily Living scale (ADL). All subjects underwent 3.0 T magnetic resonance imaging scans to obtain T 1WI, T 2WI, fluid attenuated inversion recovery (FLAIR) images and 3D-T 1 structural image data. Voxel-based morphometry (VBM) was used to analyze and compare the differences in gray matter volume between SVCI group and SIVD-NCI group. Results:Compared with the SIVD-NCI group, the MMSE score (22.00 (20.00, 24.00) vs 28.00 (27.00, 29.00), Z=-6.073, P<0.001), MoCA score (15.00 (13.00,19.00) vs 24.00 (23.00, 26.00), Z=-5.233, P<0.001), total score of CAMCOG-C (67.65±13.35 vs 88.41±10.98, t=-6.032, P<0.001) and the directional (8.00 (5.00, 9.00) vs 10.00 (9.00, 10.00), Z=-4.133, P<0.001), language (24.00 (21.00, 26.00) vs 27.00 (24.00, 28.00), Z=-3.171, P=0.002), memory (11.00 (9.00, 15.00) vs 19.00 (17.00, 21.00), Z=-4.648, P<0.001), attention (4.00 (2.00, 6.00) vs 7.00 (6.00, 7.00), Z=-3.929, P<0.001), executive (8.00 (6.00, 10.00) vs 11.00 (9.00, 12.00), Z=-3.696, P<0.001), calculation (2.00 (2.00, 2.00) vs 2.00 (2.00, 2.00), Z=-2.528, P=0.011), thinking (6.00 (3.00, 6.00) vs 6.00 (6.00, 8.00), Z=-4.029, P<0.001), perception (6.00 (6.00, 7.00) vs 8.00 (7.00, 9.00), Z=-4.221, P<0.001) in the SVCI group were obviously decreased. ADL score (21.00 (20.00, 26.00) vs 20.00 (20.00, 20.00), Z=-2.634, P=0.008) and Stroop test score (28.61±4.53 vs 20.04±6.07, t=5.704, P<0.001) were significantly higher in the SVCI group than in the SIVD-NCI group. The total gray matter volume ((556.86±49.19) mm 3vs (618.13±51.73) mm 3, t=-3.572, P=0.001) and white matter volume ((479.35±48.17) mm 3vs (507.22±43.84) mm 3, t=-2.141, P=0.037) in the SVCI group were smaller than that in the SIVD-NCI group. VBM analysis showed that the SVCI group had significantly smaller gray matter volume in the left inferior temporal gyrus ( t=5.17, P<0.001, family wise error (FWE) correction), right middle temporal gyrus ( t=4.99, P<0.001, FWE correction), right orbital superior frontal gyrus ( t=5.02, P<0.001, FWE correction), left middle occipital gyrus ( t=5.67, P<0.001, FWE correction), right middle occipital gyrus ( t=5.77, P<0.001, FWE correction). MoCA score was positively correlated with the volume of gray matter in the left inferior temporal gyrus of patients with SIVD ( r=0.292, P<0.05), language function score was positively correlated with the volume of gray matter in the left inferior temporal gyrus ( r=0.322, P<0.05), and Stroop test score was negatively correlated with gray matter volume in the left inferior temporal gyrus ( r=-0.329, P<0.05). Conclusion:Gray matter atrophy exists in multiple brain regions in patients with SVCI, and these atrophic brain regions are associated with cognitive impairment of SIVD.

Objective:To study the clinical application effect of modified nasopharyngeal swab sampling for 2019 novel coronavirus nucleic acid detection.Methods:This study covered the period from January 14 to March 1, 2020.The supine position method and the protective face screen were used to collect nasopharyngeal swabs from February 24 onwards, before which, the nasopharyngeal swabs were collected by sitting position method. All the patients who were diagnosed with suspected/confirmed 2019 novel coronavirus infection were admitted from February 19 with the nasopharyngeal swabs collected outside the hospital before admission. (1) Thirty-four swabbing operators meeting the inclusion criteria of the study were recruited in this retrospective cohort study. They were grouped according to the collection method of nasopharyngeal swabs. Sixteen operators of Wuhan Taikang Tongji Hospital who applied the supine position method and the protective face screen were included in supine position method+ protective face screen group (15 males and 1 female, aged 34-49 years); 18 operators (12 from the First Affiliated Hospital of Army Medical University (the Third Military Medical University), 1 from Wuhan Jiangxia Mobile Cabin Hospital, 5 from the East District of People′s Hospital of Wuhan University) who applied the traditional sitting position method were included in sitting position method group (2 males and 16 females, aged 25-49 years). In supine position method+ protective face screen group, when collecting sample, the patient lay flat and wore a special protective face screen for nasopharyngeal swab sampling, with neck slightly extending and face turning to the opposite side of the operator about 10°. The self-designed questionnaire was used to investigate the cooperation, the incidence of nausea, coughing, sneezing, and struggling of patients evaluated by the operators, the operation time for a single swab sample, the fear of operation and the perceived exposure risk of operators in the two groups. (2) Sixty-five patients (22 males and 43 females, aged 25-91 years) admitted to Wuhan Taikang Tongji Hospital who successively received the sitting position method and supine position method+ protective face screen for nasopharyngeal swabs sampling and with complete nucleic acid detection results were included. The positive rates of nucleic acid detection by the two sampling methods of nasopharyngeal swabs of the patients were statistically analyzed. (3) Forty-one patients who could express their feelings accurately were selected out of those 65 patients (12 males and 29 females, aged 27-83 years). The comfort of patients in the process of sampling by the two methods was investigated. (4) Thirty-four patients (10 males and 24 females, aged 25-83 years) with two or more consecutive negative results of nucleic acid detection of nasopharyngeal swabs by sitting position method were selected from the above 65 patients. The positive rate of nucleic acid detection of nasopharyngeal swab of patients by supine position method+ protective face screen, i. e. negative to positive rate was statistically analyzed. Data were statistically analyzed with t test, Wilcoxon signed rank test, and chi-square test. Results:(1) Compared with those of sitting position method group, the cooperation score of patients evaluated by the operators in supine position method+ protective face screen group was significantly higher ( Z=-4.928, P<0.01), the incidence of nausea, choking cough, sneezing, and struggling of patients evaluated by the operators, and the fear of operation score and the perceived exposure risk score of operators in supine position method+ protective face screen group were significantly lower ( Z=-5.071, -5.046, -4.095, -4.397, -4.174, -5.049, P<0.01), and the operation time for a single swab sample in supine position method+ protective face screen group was significantly longer ( t=223.17, P<0.01). (2) The positive rate of nucleic acid detection of nasopharyngeal swabs by supine position method+ protective face screen was 60.00% (39/65), which was obviously higher than 41.54% (27/65) by sitting position method ( χ2=4.432, P<0.05). (3) The comfort score of the 41 patients during nasopharyngeal swabs sampling by supine position method+ protective face screen was significantly higher than that by sitting position method ( Z=-5.319, P<0.01). (4) Of the 34 patients with two or more consecutive negative results of nucleic acid detection of nasopharyngeal swabs by sitting position method, the rate of negative to positive of nucleic acid detection was 26.47% (9/34) after sampling by supine position method+ protective face screen. Conclusions:Compared with the traditional sitting position method, detection of 2019 novel coronavirus nucleic acids of nasopharyngeal swabs collected by supine method combined with protective face screen is worth promoting, because of its better comfort of patients, low exposure risk for operators, in addition to reducing in the false negative result to some extent, which may help reduce false recurrence of discharged patients.

Objective: To investigate IMRT planning process using the combined application of failure modes and effects analysis (FMEA) and fault tree analysis (FTA) by reference to the report of Task Group 100 of the AAPM, and stablish and optimize the quality. Methods: A multidisciplinary team detailed the process mapping of IMRT planning using Eclipse TPS. The team evaluated the potential failure modes (FMs) of every process step. The evaluation was divided into two groups according to whether quality management (QM) was considered. For every FM, occurrence (O), severity (S) and detectability (D) by consensus were evaluated, and the product of O, S and D yielded the risk priority number (RPN), which permitted the ranking of the FMs. Finally, FTA was used to determine the root factors contributing to the riskiest failure modes. Results: The IMRT plan process consisted of 10 major sub-processes and 33 steps, which amounted to 47 failure modes. For the group without quality management, the RPN of FMs was between 13.2-271.8, 27 of which had RPN≥80, and 18 FMs had S≥8. For the group with quality management, the RPN of FMs was between 11.2-158.4, 11 of which had RPN≥80. The difference of RPN between the two groups was statistically significant (RPN of the group without QM=101.17±66.34, RPN of the group with QM=59.54±35.64, t=8.501, P<0.05). Finally, FTA was used to determine the root factors contributing to the FMs, i. e., prescription dose definition and importing images. Conclusions The FMEA and FTA methods are operable and practical, which can systematically and comprehensively analyze the potential failures and risks existing in the process of IMRT plan. And the FMEA and FTA can contribute to establish and optimize the quality management program in radiotherapy.

Objective To investigate the correlation between methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and plasma homocysteine (Hcy) levels and white matte hyperintensities (WMHs). Methods PubMed, EMbase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Weipu and Wanfang databases were retrieved to search studies on correlation between MTHFR gene C677T polymorphism and plasma Hcy levels and WMHs. The search deadline was October 31, 2018. Stata 14.0 software was used for statistical analysis. Results Six eligible literatures on the correlation between MTHFR gene and WMHs were included. The results of meta-analysis showed that there was no significant correlation between MTHFR C677T gene polymorphism and WMHs in 5 genetic models (T allele vs. C allele, TC vs. CC genotype, TT vs. CC genotype, TT+TC vs. CC genotype, and TT vs. TC+CC genotype). A total of 22 eligible literatures on the correlation between plasma Hcy level and WMHs were included. The results of meta-analysis showed that the plasma Hcy levels in patients with WMHs were significantly higher than those in the control group (weighted mean difference 3.48, 95% confidence interval 2.36-4.60; Z=6.03, P<0.01). Conclusions There was no significant correlation between MTHFR gene C677T polymorphism and WMHs, and the elevated plasma Hcy levels may be a risk factor for WMHs.