Low-speed centrifugation based isolation and Personal Glucose Meter assisted synchronous quantification of Pseudomonas aeruginosa in nursing home-acquired pneumonia.

Home-acquired pneumonia is a common infection and the incidence has increased in recent years as the population ages. Pseudomonas aeruginosa (P. aeruginosa) is common in nursing home residents and in hospital infections, providing a huge threat to human health. Therefore, it is essential to develop a novel and portable P. aeruginosa analysis method for the early diagnosis of home-acquired pneumonia. Few of the established approaches enable isolation and synchronous quantification of P. aeruginosa. Herein, we propose a novel platform by integrating aptamer recognition-based aggregation of target bacteria and personal glucose meters (PGMs) based readout of results. Based on this, the method enables low-speed centrifugation (4193 g) based isolation and personal glucose meter assisted synchronous quantification of P. aeruginosa. In addition, the chain displacement process is included for signal amplification that endows the method with a wide detection range of six orders of magnitudes and a low limit of detection of 36 cfu/mL. Besides the excellent sensitivity, the approach also shows a good selectivity to P. aeruginosa detection, making it a promising tool to report P. aeruginosa based home-acquired pneumonia and guiding the early-nursing of P. aeruginosa infections at the emergency department.

Patient safety value, safety attitude and safety competency among emergency nurses in China: A structural equation model analysis.

AIMS: We aim to determine the levels of patient safety value, safety attitude and safety competency and to explore the associations among these variables in emergency nurses in China. BACKGROUND: Studies have focused on the individual characteristics of nurses as influencing factors of patient safety but not on the factors that may affect patient safety competency in the context of Chinese culture, such as safety value and safety attitude. METHOD: A cross-sectional survey was conducted among emergency nurses in 22 hospitals. RESULTS: The final model had acceptable fit indices (χ2 /df = 3.512 < 5; CFI = 0.955 > 0.9; TLI = 0.942 > 0.9; IFI = 0.955 > 0.9; RMSEA = 0.068 < 0.08 [90% CI, 0.059 to 0.077]). A fully adjusted model was also tested, and the effects among variables were consistent with the hypothesized model. The SEM results showed that patient safety values had a significant direct effect on safety competency (b = .407, p < .001) and safety attitude (b = .656, p < .001). Patient safety attitude had a significant direct effect on safety competency (b = .493, p < .001). Patient safety values had an indirect effect on safety competency through safety attitude, and the total effect of safety values on safety competency was 0.730. CONCLUSIONS: Chinese nurses are at a moderate level of patient safety attitude and competency. Emergency nurses' safety value and safety attitude can be direct predictors of patient safety competency, and safety value can indirectly predict their patient safety competency through safety attitude. IMPLICATIONS FOR NURSING MANAGEMENT: Strengthening safety value is a critical step toward improving patient safety competency. Hospital administrators and educators should construct a patient safety culture that is guided and driven by appropriate values and ensure the development of necessary competencies in nurses.

Echinacoside prevents hypoxic pulmonary hypertension by regulating the pulmonary artery function.

Hypoxic pulmonary hypertension (HPH) is a progressive and irreversible disease that reduces survival. Echinacoside is a phenylethanoid glycoside from Tibetan herbs known for its vasorelaxant effect and for inhibiting the proliferation of rat pulmonary arterial smooth muscle cells. This study aimed to investigate the effect of echinacoside on HPH. Sprague Dawley rats were housed in a hypobaric hypoxia chamber (4500 m) for 28 days to obtain the HPH model. Echinacoside (3.75, 7.5, 15, 30 and 40 mg/kg) was administered by intraperitoneal injection from the 1st to the 28th day. The mean pulmonary artery pressure (mPAP), right ventricular hypertrophy index, hemoglobin, hematocrit, red blood cell concentration and morphological change of pulmonary arteries were evaluated. Vascular perfusion assay was used to assess the pulmonary artery function. Echinacoside reduced mPAP, hemoglobin, hematocrit, right ventricular hypertrophy index and mean wall thickness% of pulmonary arteries in HPH rats. It significantly increased maximum vasoconstriction percentage of pulmonary arteries induced by noradrenaline in a dose-dependent manner. In addition, it improved the responsiveness of pulmonary arteries to acetylcholine and sodium nitroprusside. Therefore, Echinacoside might be an effective treatment against HPH, since it regulated pulmonary artery endothelium and smooth muscle layer function and improved the remodeling of pulmonary artery.

Factors associated with hospital choice of Chinese patients: A meta-analysis.

INTRODUCTION: While China continues to optimize the tiered medical care system, the status quo of patients preferring higher-tier hospitals has not improved. Herein, we aimed to analyze the factors influencing patients' healthcare choices in China and to provide an evidentiary basis for optimizing the tiered healthcare system. PATIENT CONCERNS: Most patients are concerned that primary care services will not provide appropriate treatment or health advice. Also, patients consider medical technology, cost, experience, quality of service and convenience before seeking care. OUTCOMES: A total of 18 cross-sectional studies involving 10,348 samples were included. After combining the effect size, the factors affecting the choice of Chinese patients for medical treatment were medical technology and quality (49%), the convenience of medical treatment (37%), medical expenses (23%), hospital service quality (20%) medical insurance policy (16%), and acquaintance relationship (11%). CONCLUSION: The selection of medical treatment for Chinese residents is primarily influenced by medical technology and convenience. The medical insurance policy does not provide sufficient guidance. Furthermore, the tiered medical care system should be optimized to improve the usability of primary care services.

Study on the Application of Modified Sn-Based Solder in Cable Intermediate Joints.

With the increasing use of underground cables, the quantity and quality of intermediate joints demanded are also increasing. The quality of the traditional crimping intermediate joint is easily affected by the actual process of the operator, which may lead to the heating of the crimping part of the wire core, affecting the insulation performance of the cable, and finally causing the joint to break. However, aluminothermic reactive technology has some problems, such as a high welding temperature and an uncontrollable reaction. In order to solve these problems, according to the brazing principle and microalloying method, the optimal content of In in Sn-1.5Cu-based solder was explored, and then the connection of the middle joint of a 10 kV cable was completed using a connecting die and electrical connection process. The contact resistance and tensile strength of the joint were tested to verify the feasibility of this method. The results show that the maximum conductivity of the solder with 3.8% and 5% In content can reach 3.236 × 106 S/m, and the highest wettability is 93.6%. Finally, the minimum contact resistance of the intermediate joint is 7.05 µΩ, which is 43% lower than that of the aluminothermic welded joint, and the tensile strength is close to that of the welded joint, with a maximum of 7174 N.

An empirical analysis of the impact of gender inequality and sex ratios at birth on China's economic growth.

The contribution of women to China's economic growth and development cannot be overemphasized. Women play important social, economic, and productive roles in any economy. China remains one of the countries in the world with severe gender inequality and sex ratio at birth (SRB) imbalance. Severe gender inequality and disenfranchisement of girls with abnormally high sex ratios at birth reflect deep-rooted sexism and adversely affect girls' development. For China to achieve economic growth, women should not be ignored and marginalized so that they can contribute to the country's growth, but the sex ratio at birth needs to be lowered because only women can contribute to growth. Thus, this study empirically predicts an asymmetric relationship between gender inequality, sex ratio at birth and economic growth, using NARDL model over the period 1980-2020. The NARDL results show that increases in gender inequality and sex ratio at birth significantly reduce economic growth in both the short and long term, while reductions in gender inequality and sex ratio at birth significantly boost economic growth in both the short and long term. Moreover, the results show the significant contribution of female labor force participation and female education (secondary and higher education) to economic growth. However, infant mortality rate significantly reduced economic growth. Strategically, the study recommends equal opportunities for women in employment, education, health, economics, and politics to reduce gender disparities and thereby promote sustainable economic growth in China. Moreover, policymakers should introduce new population policy to stabilize the sex ratio at birth, thereby promoting China's long-term economic growth.

Use of ixekizumab in an HIV-positive patient with psoriatic arthritis.

Psoriasis is a chronic immune-mediated disease of the skin. The incidence of psoriasis among people living with HIV (PLHIV) is higher than that in the general population. The mechanism is complex, the manifestations are varied, and the treatment is difficult. Biotherapy has greatly alleviated psoriasis, but clinical trials often exclude PLHIV, and evidence is limited to case reports. Here, we report a man living with psoriatic arthritis who had poor response to traditional treatments. After receiving the anti-interleukin (IL)-17 monoclonal antibody (ixekizumab), the arthritis symptoms were significantly relieved, while CD4+ T cell count increased and the viral load of HIV-1 remained undetectable in combination with antiretroviral therapy (ART). In conclusion, anti-IL-17 monoclonal antibody is a promising and safe treatment for psoriatic arthritis in HIV-positive patients.

Effect of solution-focused approach on anxiety and depression in patients with rheumatoid arthritis: A quasi-experimental study.

Introduction: Anxiety and depression are common psychological problems in rheumatoid arthritis (RA) patients. However, few effective nursing intervention models have been designed specifically to improve anxiety and depression in RA patients. Solution-focused approach (SFA) is an effective intervention method for psychosocial issues. There have been no studies involving SFA yet in RA patients. This study investigated the effects of SFA-based nursing intervention on anxiety and depression in RA patients. Methods: A quasi-experimental study using a convenience sampling of RA patients was conducted. The 48 RA patients were divided into the control group (n = 24) and the experimental group (n = 24). The control group received routine nursing intervention, while the experimental group received SFA-based nursing intervention. The scores on the self-rating anxiety scale (SAS), self-rating depression scale (SDS), arthritis self-efficacy scale-8 (ASES-8), and questionnaire on patient satisfaction with nursing care were collected before and after nursing interventions. Results: Between-Group Comparison: Before the nursing intervention, there was no statistically significant difference in the SDS, SAS, and ASES-8 scores between the two groups (p > 0.05). However, after the nursing intervention, the SDS and SAS scores of the experimental group were statistically significantly lower than those of the control group (p < 0.05). In contrast, the ASES-8 score of the experimental group was statistically significantly higher than that of the control group (p < 0.05). In addition, patient satisfaction with nursing care of the experimental group was better than that of the control group (p > 0.05). Within-Group Comparison: There was no statistically significant difference in the SDS, SAS, and ASES-8 scores in the control group before and after routine nursing intervention (p > 0.05). However, in the experimental group, the SDS and SAS scores before SFA-based nursing intervention were statistically significantly higher than those after SFA nursing intervention (p < 0.05), and the ASES-8 score before SFA-based nursing intervention was considerably lower than that after SFA nursing intervention (p < 0.05). Discussion: SFA-based nursing intervention can effectively improve anxiety, depression, and arthritis self-efficacy of RA patients. This study broadens clinical psychological nursing intervention models for RA patients. SFA may be an effective nursing model for various psychosocial problems in the current medical context.

Simultaneous determination of three antituberculosis drugs in the serum of patients with spinal tuberculosis by capillary electrophoresis.

The pharmacokinetic variations of a single drug in an antituberculosis regimen are associated with acquired drug resistance and therapy failure. This study aimed to develop a simple and effective method for monitoring the serum levels of isoniazid (INH), rifampicin (RFP), and pyrazinamide (PZA), three antibiotics used in patients with spinal tuberculosis using capillary electrophoresis (CE). A standard solution of INH, RFP, and PZA was prepared and mixed with serum to prepare the standard curve. The detection limit, quantification limit, precision, stability, repeatability, and sample recovery were determined. Then, INH, RFP, and PZA were measured from the leftover serum samples of all patients with spinal tuberculosis who were treated with 2SHRZ/2.5H2R2Z2 combined with surgery in a tertiary hospital in Qinghai from October 2015 to September 2017. A total of 107 patients with spinal tuberculosis treated using the 2SHRZ/2.5H2R2Z2 regimen combined with surgery were included in this study. All three antibiotics had linear standard curves with high correlation coefficients (R2 = 0.9997, 0.9994, and 0.9986). The recovery rates were 98.1% for INH, 96.5% for PZA, and 97.2% for RFP. The results from the serum samples showed that the plasma concentrations of INH (4.989 ± 1.692 µg mL-1) and RFP (9.400 ± 1.711 µg mL-1) reached effective therapeutic concentrations in all patients, but not PZA (33.860 ± 1.830 µg mL-1). The CE method for measuring INH, RFP, and PZA simultaneously in serum samples of patients with spinal tuberculosis is simple, rapid, and sensitive. This method is suitable for the routine monitoring of INH, RFP, and PZA concentrations in the serum of patients with spinal tuberculosis.

Rapid, sensitive and cost-effective determination of immune checkpoint inhibitor activity using a magnetic bead-based binding assay.

Immune checkpoint Inhibitors (ICIs) are effective immunno-therapeutic agents for cancer. Rapid and sensitive determination of the blocking activity of ICIs is important for ICIs development and immunological research. Among various immune checkpoint (IC) binding assays, cell-based binding assays are widely regarded, and the functional ELISA is a convenient alternative. However, these methodologies are limited by time-consuming preparation of cell lines stably expressing IC molecules, or long turnaround time with high cost. In this study, two magnetic bead based binding assays were developed to evaluate activity of ICIs, which was determined by a soluble ligand/bead immobilized receptor based binding assay (sL/bR binding assay) that assessed efficacy to block binding of one soluble IC ligand on its cognate receptor immobilized beads, or by a soluble receptor/bead immobilized ligand based binding assay (sR/bL binding assay) that assessed efficacy to block binding of soluble IC receptor on its cognate ligand immobilized beads. Half maximal inhibitory concentration (IC50) values of ICIs were calculated to determine ICIs activity. The sL/bR binding assay accurately determined the activity of two TIGIT blocking antibodies, since the relative blocking activity of two TIGIT antibodies determined by the sL/bR binding assay established in this study and that by the cell based binding assay were almost identical. In contrast, the sR/bL binding assay showed significantly improved sensitivity to determine activity of two PD-1 blocking antibodies than the sL/bR binding assay that was tested in this study and previous reports. Moreover, both amount of the used recombinant protein of ICI receptor/ligand and turnaround time of the two binding assays were more than 10 times less than those of the functional ELISA. These data indicate that the two magnetic bead based binding assays are sensitive, rapid and cost-effective methods to determine blocking activity of ICIs.

Bone and joint tuberculosis in patients undergoing dialysis: clinical features, risk factors, and outcomes in 17 patients.

OBJECTIVE: This study was performed to investigate the clinical features, risk factors, and outcomes of bone and joint tuberculosis in patients undergoing dialysis. METHODS: We systematically reviewed the medical records of 17 patients with bone and joint tuberculosis undergoing dialysis who were admitted to our hospital from January 2009 to January 2019. RESULTS: Seventeen patients with bone and joint tuberculosis undergoing dialysis were identified in this retrospective study, and 13 patients were undergoing hemodialysis. The mean age of the 17 patients was 61.3 years (range, 32-82 years), and 10 (58.9%) patients were male. Most of the patients had a low CD4+ cell count and low hemoglobin and albumin levels. Surgery was performed in 6 patients (35.3%), and 13 of the 17 patients (76.4%) were cured. Three patients had bone or spine sequelae, mainly because of a delayed diagnosis, and one patient died of heart failure. CONCLUSION: These findings indicate that older age, a low CD4+ cell count, and low hemoglobin and albumin levels are possible risk factors for bone and spine tuberculosis in patients undergoing dialysis. If diagnosed early, most patients should have a good outcome after anti-tubercular therapy with or without surgery.

Endothelial nitric oxide synthase gene intron 4, 27 bp repeat polymorphism and essential hypertension in the Kazakh Chinese population.

To investigate the relationship between 27 bp repeat polymorphism in intron 4 in the endothelial nitric oxide synthase (eNOS4) gene and essential hypertension in the Kazakh Chinese population, 151 patients with essential hypertension and 138 healthy people were selected from the Boertonggu countryside of Shawan region in the Xinjiang uygur autonomous region of China in 2006. The polymorphism of eNOS in the two groups was detected with polymerase chain reaction assays and the genotype frequencies in each group were calculated following the Hardy-Weinberg law. Four and five tandem 27 bp repeats were designated as "a" and "b", respectively. It was found that the frequencies of b/b, b/a and a/a genotypes of the eNOS4 gene were 84.06%, 15.22% and 0.72% in the control group, and 81.46%, 15.89% and 2.65% in the hypertension group, respectively. The frequencies of gene "a" and "b" were 91.67% and 8.33% in the control group and 89.40% and 10.60% in the hypertension group, respectively. It was found that plasma eNOS activity was not associated with genotypes and alleles of eNOS gene. Plasma eNOS activity in the hypertension group was significantly decreased compared with the control group (P<0.01). The results suggest that eNOS4 gene polymorphisms are unlikely to be the major genetic susceptibility factors for essential hypertension in the Xinjiang Kazakh population. However, a positive association between plasma eNOS activity and essential hypertension has been revealed.