Objective To provide an animal model for studying the effect of TDO2 on the function of macrophages on the occurrence and development of diseases by constructing macrophage-specific tryptophan,2,3-dioxygenase(TDO2)gene knockout mice.Methods TDO2flox/flox Lyz2-iCre+mice were constructed based on Cre/LoxP sys-tem.The genotypes of mice were identified by PCR amplification and agarose gel electrophoresis.Western blot and immunofluorescence were used to verify the effect of TDO2 knockdown in mouse macrophages.The spontaneous le-sions in major tissues and organ were observed by HE stainings.Results The results of genotype identification showed that the mice with only one band at 407 bp or 408 bp for the flox amplification product and one band at 543 bp for the Cre amplification product were TDO2flox/flox Lyz2-iCre+mice.Western blot results showed that TDO2 ex-pression in bone marrow-derived macrophages(BMDMs)of TDO2flox/flox Lyz2-iCre+mice decreased compared with TD02flox/flox mice(P＜0.01).Immunofluorescence results showed that TDO2 expression in peritoneal macrophages and BMDMs of TDO2flox/flox Lyz2-iCre+mice decreased compared with TDO2flox/flox mice.HE staining showed no sig-nificant differences in cell morphology in the liver,brain,kidney and spleen tissues of TDO2flox/flox Lyz2-iCre+mice compared to TDO2flox/f1ox mice.Conclusion TDO2flox/flox Lyz2-iCre+mice is successfully constructed,providing a more precise experimental animal model for subsequent in-depth study of the role and mechanism of TDO2-regulated macrophage activation in disease.

Objective:To explore the ventilation strategy of using pressure controlled ventilation-volume guaranteed (PCV-VG) mode combined with personalized positive end expiratory pressure (PEEP) during surgery, and its impact on oxygenation function and incidence of postoperative pulmonary complications (PPCs) in patients undergoing brain tumor surgery.Methods:Sixty patients who underwent elective brain tumor surgery at the Linyi People′s Hospital from January 2023 to June 2023 were selected. The patients were randomly divided into PCV-VG ventilation mode group (T group) and volume controlled ventilation (VCV) mode group (C group) using a random number table method, with 30 patients in each group. One patient was excluded from group T due to changes in the condition, and 29 patients were actually included. Group T adopted PCV-VG ventilation mode and searched for the maximum dynamic lung compliance (Cdyn) by titrating PEEP. The PEEP corresponding to the maximum Cdyn value was the optimal PEEP, which was maintained until the end of mechanical ventilation. Group C adopted a ventilation mode of VCV plus 5 cmH 2O fixed value PEEP. All patients underwent arterial blood gas analysis before anesthesia induction (T 1), 15 minutes after setting ventilation mode (T 2), and 15 minutes after extubation (T 3), recording arterial oxygen partial pressure (PaO 2), carbon dioxide partial pressure (PaCO 2), lactate (Lac), and blood glucose (Glu), and calculating oxygenation index (PaO 2/FiO 2). The levels of white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were recorded before and 72 hours after surgery. The incidence of postoperative PPCs at 72 hours was observed. Results:There was a statistically significant difference in the grouping effect and time effect of PaO 2 and PaCO 2 between group C and group T (all P<0.05), while there was no statistically significant difference in the interaction effect (all P>0.05); The differences in grouping effects, time effects, and interaction effects of PaO 2/FiO 2 between group C and group T were statistically significant (all P<0.05); The average value of the optimized PEEP obtained by T-group titration was 7.48 cmH 2O, corresponding to an average platform pressure (Pplat) of 14.90 cmH 2O, and an average value of 53.37 ml/cmH 2O corresponding to the maximum Cdyn value. Compared with the Pplat and Cdyn corresponding to the fixed value of 5 cmH 2O PEEP in Group C, the Pplat corresponding to the optimized PEEP in Group T was lower than that in Group C ( P<0.05), and the Cdyn was higher than that in group C ( P<0.05). The CRP level and incidence of PPCs in group T after 72 hours of surgery were significantly lower than those in group C (all P<0.05). Conclusions:Compared with VCV, the ventilation mode of PCV-VG combined with personalized PEEP can improve intraoperative lung ventilation and oxygenation function in patients with brain tumors, reduce the occurrence of pulmonary inflammation 72 hours after surgery, and lower the incidence of PPCs.

Objective:To explore whether or not radioactive wastewater leakage or overflow exists in the nuclear medicine decay pool after the 7·20 extraordinary rainstorm disaster and to analyze its causes, so as to provide scientific basis for the design, construction and maintenance of the nuclear medicine decay pool and the radiation protection management of nuclear medicine in the future.Methods:Three hospitals A, B and C where 131I therapy are being performed were selected in Zhengzhou city, Henan province. Sampling points were set based on the monitoring result of the environmental radiation level around the nuclear medical decay pool in line with the relevent standard method. Soil samples were collected at different depths. The 131I radioactivity level in the soil was measured using HPGe gamma spectrometer, with the measured result being processed and analyzed. Results:Except for Hospital B where no 131I was detected, different 131I activity concentrations were detected in the soil samples collected around the nuclear medicine decay pool at Hospitals A and C. The 131I activity concentrations ranged from 16.4 to 98 111.8 Bq/kg at Hospital A and from 10.6 to 7 176.6 Bq/kg at Hospital C. After a time period of decay, the repeated detection has shown that the 131I activity concentrations ranged from 1.3 to 17.0 Bq/kg at Hospital A and from 3.9 to 7.1 Bq/kg at Hospital C. The 131I activity concentration in the soil at the depth of 0-5 cm was higher than that at the depth of 5-10 cm soil at the same sampling point. The ratios of activity concentration of 131I between different depths ranged from 1.3 to 13.1, with the median value of 5.9. Conclusions:After the 7·20 extraordinary rainstorm disaster, the surrounding environment of nuclear medicine decay pools at a few hospitals was contamminated by 131I to some extent. To prevent the risk of leakage of radioactive wastewater, the safety evaluation and management of radiation protection should be made better with increased awareness during the design, evaluation, construction and use of nuclear medicine decay pools.

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

Objective:To investigate the clinical manifestations of population following COVID-19 by using questionnaires.Methods:COVID-19 among anesthesia workers and the surrounding population was investigated between 11 November 2022 and 31 December 2022 in China.The Tencent electronic questionnaire(ID.11492813) was sent to different WeChat groups of the Association of Anesthesiologists or Society of Anesthesiologists via the WeChat platform of the medical personnel in China. The survey was conducted between January 7 and January 15, 2023. Results:A total of 17 000 questionnaires were issued for this survey, 11 060 valid questionnaires from 31 provinces and autonomous regions were collected all over the country, with a recovery rate of 65.059%.There were 10068 (91.037%) participants diagnosed as having COVID-19, and among of them, 47.606% were male and 52.394% were female. The main post-COVID-19 clinical manifestations included fever (85.777%), cough (83.731%), fatigue (75.338%), parasomnia (64.352%), limb soreness (58.890%), dizziness, headache, tinnitus (38.617%), loss or abnormality of taste (37.763%), and loss or abnormality of smell (30.960%); peripheral neuralgia was usually found within 3 days after positive nucleic acid test or positive antigen test; there were 2 963 cases accompanied with sweating, and among of them, 47.25% were male and 52.75% were female, and 37.80% of these participants continued to sweat after the nucleic acid test or antigen test became negative. There were 1 151 cases with premature heart beats among the study population, and the symptoms aggravated following COVID-19 were found in 34.32% of these patients.Conclusions:In addition to the respiratory system, the central and peripheral nerves of patients are also affected following COVID-19, and the peripheral and central nerve disorders last until several days after negative nucleic acid test or antigen test, suggesting that anesthesiologists should pay more attention to monitoring of various nerve function and impact of surgery and anesthetic drugs on the stress response of the body in such patients.

Objective: To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm (BEB). Methods: A prospective randomized controlled trial was performed. A total of 105 participants were randomized 1:1:1 into an acupuncture group, a herbal medicine group and an acupuncture plus herbal medicine group. Participants in the acupuncture group received manual acupuncture treatment, twice a week. Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang, oral administration, once a day. Participants in the acupuncture plus herbal medicine group received both treatments. The therapeutic effects of the three groups were evaluated after four weeks of treatment. The primary outcome was the Jankovic rating scale (JRS) score, and the secondary outcome was the blepharospasm disability index (BSDI) score. Results: After four weeks of treatment, the JRS total scores significantly decreased in all three groups versus baseline (P<0.05). A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group (P<0.05), but there was no significant difference between the acupuncture group and the herbal medicine group (P>0.05). The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group (P<0.05). The reduction in the JRS frequency score was not significantly different among the three groups (P>0.05). The BSDI scores significantly decreased in all three groups versus baseline (P<0.05), but the reduction in the BSDI score was insignificantly different among the three groups (P>0.05). Conclusion: It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination. The combination therapy shows a more significant effect than either of the treatment alone.

Objective:To explore the status quo of elder abuse tendencies among nursing staff in nursing homes and analyze its influencing factors.Methods:The convenient sampling method was adopted to select 342 nursing staff from 26 nursing institutions in Zhengzhou from April to October 2020 as the research objects. The general information questionnaire, the Caregiver Abuse Screen (CASE) , Workplace Social Capital (WSC) and Maslach Burnout Inventory General Survey (MBI-GS) were used to investigate the caregivers. Univariate analysis and Logistic regression analysis were used to explore the influencing factors of elder abuse tendency by nursing staff. A total of 342 questionnaires were distributed and 325 valid questionnaires were recovered, with the effective recovery rate of 95.0%.Results:A total of 65.5% (213/325) of the nursing staff had the tendency of elder abuse. Logistic regression analysis showed that the self-care ability type of elders in charge and emotional exhaustion of nursing staff were risk factors for elder abuse tendency of nursing staff ( P<0.05) , and workplace social capital was protective factor for elder abuse tendency of nursing staff ( P< 0.05) . Conclusions:Elderly caregivers have a high tendency to abuse the elderly. The tendency of caregivers to abuse the elderly should be dynamically assessed. Institutional managers should strengthen their support to the caregivers, reduce the number of disabled elderly people who are taken care of by caregivers, provide team support and psychological counseling and reduce the risk of abuse of the elderly.

Objective:To explore the effect of electronic nursing delivery sheet based on knowledge-to-action (KTA) model in stroke patients.Methods:From January 2019 to December 2020, convenience sampling was used to select 140 stroke patients in the Rehabilitation Department of Henan Provincial People's Hospital as the research object. The patients who were hospitalized from January to December 2019 were set as the control group, and the patients who were hospitalized from January to December 2020 were set as the observation group, with 70 cases in each. The control group adopted bedside oral delivery mode, and the observation group conducted the electronic nursing delivery sheet based on the KTA model. The Chinese version of the Nursing Assessment of Shift Report (NASR) and the Generic Quality of Life Inventory-74 (GQOL-74) were used to evaluate the quality of nurse shift and the quality of life of the two groups of patients before and after intervention.Results:The total score and dimension scores of the NASR of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.01) . After intervention, the scores of all dimensions of GQOL-74 in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of electronic nursing delivery sheet based on the KTA model in stroke patients can improve the quality of nurse shift and the quality of life of patients.

Listeria monocytogenes (Lm) is zoonotic pathogen that can cause listeriosis, and vaccine is one of the effective methods to prevent this pathogen infection. In this study, we developed a novel vaccine that is a mixture of inactivated bacteria and Montanide™ ISA 61 VG, a mineral oil adjuvant, and evaluated the safety and immune response characteristics of this vaccine. The mice immunized with the ISA 61 VG adjuvant had high safety, and it could induce significantly higher titer of anti-listeriolysin O (LLO) antibody and higher value of IgG2a/IgG1 ratio compared with the group without the adjuvant. In particular, it could provide 100% immune protection against lethal doses of Lm challenge in mice. In summary, ISA 61VG adjuvant significantly enhanced the ability of inactivated listeria vaccine to induce humoral and cellular immune responses, thereby enhanced the protective immune response in the host, and it is a potential vaccine candidate for the prevention of Lm infection in humans and animals.
Adjuvants, Immunologic ; pharmacology ; Animals ; Hemolysin Proteins ; immunology ; pharmacology ; Immunity, Cellular ; drug effects ; Listeria monocytogenes ; immunology ; Listeriosis ; prevention & control ; Mice ; Mice, Inbred BALB C ; Vaccines, Inactivated ; immunology

Objective:To explore the feasibility of using a High-Throughput Chromosome Automatic Scanning System (Metafer 4) to carry out automatic micronucleus detection for radiation workers.Methods:A total of 2 005 radiation workers selected were divided into five groups in terms of diagnostic radiology, radiotherapy, nuclear medicine, interventional radiology and industrial application.The Metafer 4 was used to assay micronuclei in peripheral blood lymphocytes from the subjects, with the factors affecting micronuclei analyzed. A total of 200 micronucleus samples collected by stratified random sampling were manually assayed for comparison of micronuclei frequency and detection efficiency between automatic and manual analysis.Results:The mean micronuclei frequency in 2 005 radiation workers were measured to be (0.92±0.02) ×10 -3. There was significant difference in the frequencies of micronuclei among the five groups ( χ2=11.054, P<0.05), with higher micronuclei frequency in interventional radiology group(1.00±0.03) ×10 -3 than in other groups ( χ2=5.568, 5.334, 7.689, P<0.05). Statistically significant difference could be observed in annual effective dose, length of service and micronuclei frequency among the radiation workers in different medical applications ( F=3.026, χ2=11.582, 8.878, P<0.05). A positive correlation between annual effective dose and micronucleus frequency was shown by Pearson analysis ( r=0.106, P<0.05). Multiple linear regression analysis showed that the automatic assay-based micronuclei frequencies were associated with length of service and work categories( r=9.485×10 -6, 5.660×10 -5, P<0.05), significantly lower when compared with manual analysis ( χ2=169.259, P<0.05). There was a consistency (ICC=0.713, P<0.05) between the two assay methods, but automatic analysis can increase the assayed micronucleus frequency by about 5 folds. Conclusions:The micronucleus frequency tested by automatic detection reflects genetic damage from low-dose chronic radiation exposure, and there may be feasibility of using automatic analysis to assay micronucleus of radiation workers.