The Effects of Bronchoalveolar Lavage Combined with Microbiological Rapid on-site Evaluation in the Maintenance of Potential Donor Lung / 昆明医科大学学报

Objective To explore the effects of bronchoalveolar lavage combined with microbiological rapid on-site evaluation in potential donor lung maintenance.Methods Brain death patients who met the inclusion criteria and were admitted to the Intensive Care Unit(ICU)of Calmette Hospital Affiliated to Kunming Medical University from September 2020 to December 2022 were selected for bronchoalveolar lavage(BAL)and(BAL)and the lavage fluid were collected for M-ROSE to compare the pathogen detection rate and initial diagnosis time.According to the positive results of the microbiological rapid on-site evaluation,patients with the brain death were treated with empirical anti-infective therapy,and the oxygenation index,chest X-ray score,and the infection index(WBC,CRP,PCT)of anti-infective treatment 48 hours were evaluated.Results 1.Comparison of the detection rate of pathogenic microorganisms:The results of M-ROSE were highly consistent with a routine microbiological smear(Kappa = 0.921,P<0.001).2.Comparison of diagnostic time:The initial diagnosis time of M-ROSE was significantly lower than routine microbiological smear time and microbial culture time(P<0.001).3.Comparison of therapeutic effects of anti-infective therapy for 48 hours:There was no significant difference in oxygenation index,white blood cells and hypersensitive C-reactive protein before and after the anti-infective treatment(P>0.05).There were significant differences in procalcitonin and chest X-ray before and after the anti-infective treatment(P<0.05).Conclusion Bronchoalveolar lavage combined with microbiological rapid on-site evaluation has the high timeliness in the diagnosis of potential donor pulmonary infection,which can provide a preliminary basis for the early anti-infective therapy of donor lung maintenance.

An epidemiological investigation on vaccine-hypervariable poliovirus in a case with acute flaccid paralysis in Zhejiang Province / 预防医学

Abstract@#Vaccine-hypervariable poliovirus type Ⅲ was detected in an acute flaccid paralysis infant at age of 6 months in Zhejiang Province in June, 2021, and the isolated and incubated virus had six nucleotide variations in the VP1 region as compared to the poliovirus Sabin vaccine strain. The infant had a history of three-dose poliovirus vaccination, and grade 2 muscle strength of the left upper limb upon onset. He was clinically diagnosed with cellulitis of the left shoulder, and recovered to normal following treatment. No abnormality was detected in the nervous system, and the infant was cured and discharged from hospital. No vaccine-hypervariable poliovirus was detected in subsequent infant' clinical samples or in close contacts, and no similar cases were identified during the active case detection by county/district medical institutions and among community populations. Since the infant did not present poliomyelitis-related clinical symptoms caused by vaccine-hypervariable poliovirus, poliomyelitis was excluded. The vaccine-hypervariable poliovirus was not spread because of timely identification and effective responses, suggesting the urgent need to maintain the sensitivity of the acute flaccid paralysis surveillance system and improve the coverage of poliovirus vaccination, so as to inhibit the transmission of poliovirus.

Research advances in peptide‒drug conjugates

Peptide‒drug conjugates (PDCs) are drug delivery systems consisting of a drug covalently coupled to a multifunctional peptide via a cleavable linker. As an emerging prodrug strategy, PDCs not only preserve the function and bioactivity of the peptides but also release the drugs responsively with the cleavable property of the linkers. Given the ability to significantly improve the circulation stability and targeting of drugs in vivo and reduce the toxic side effects of drugs, PDCs have already been extensively applied in drug delivery. Herein, we review the types and mechanisms of peptides, linkers and drugs used to construct PDCs, and summarize the clinical applications and challenges of PDC drugs.

Experience of nurses in combined care program of traditional Chinese medicine:a qualitative research / 中国实用护理杂志

Objective To describe the experience of nurses in combined care program of traditional Chinese medicine (TCM) and provide references for nursing managers. Methods The phenomenology research method was adopted in this study. Fourteen nurses who had achieved the combined care program of TCM participated in an in-depth interview. Data were analyzed by using phenomenological analysis. Results All nurses approved nursing program of TCM: finding sense of belonging in nursing work;demonstration of self-value;standardization of nursing tednnique;harmonious environmont of nursing work. But some defect still existed: too subjective evaluation item of nursing program of TCM;inappropriate evaluation table;lact of hospital characteristics of TCM nursing;deficiency of TCM knowledge. Conclusion Nursing managers should pay more attention to nurses' emotional experience, grasp the implementation of the problems during the program and improve the program, optimize the skills, provide trainings.

Etiology and molecular-epidemiological characteristics of viral meningoencephalitis of Zhejiang province in 2013 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate pathogens and molecular-epidemiology characteristics of viral meningoencephalitis in the monitoring sites of Zhejiang province, 2013.</p><p><b>METHODS</b>Cerebrospinal fluid and/or stool specimens were collected from suspected patients admitted to the monitoring hospitals in southern and northern Zhejiang province. Such specimen were subject to real-time qPCR for the detection of Human enterovirus (HEV), Japanese encephalitis virus (JEV), Mumps virus (MuV), Herpes simplex virus (HSV) and Cytomegalovirus (CMV). HEVs were isolated using the RD and Hep-2 cell lines, while VP1 genes from all HEV-positive isolates or RNA-positive specimen were amplified, sequenced, for homology and evolution analysis.</p><p><b>RESULTS</b>92 (38.5%) of the 239 samples collected from 229 patients were detected as virus nucleic acid positive, including 87 HEV positive samples, 1 MuV positive, 2 HSV positive, and 2 CMV positive; of the 87 HEV positive samples, 38 were further determined to be Coxsackievirus (CV) and 49 as Echovirus (E). 56 HEV strains were isolated from 239 (23.4%) samples. From the 31 cerebral fluid specimen of nucleic acid positive yet virus isolation negative, the most specimen were identified with E9 (9 specimen), followed by CVA9 (8 specimen); the viral serotype of Zhejiang province HEV were CVA9, CVB4, CVB5, E6, E7, E9, E11, E14, E16, E25 and E30, respectively. Predominant epidemic strains identified at southern and northern Zhejiang province were CVB5 and E6 respectively. The phylogenetic analysis of VP1 gene showed that all the HEV isolates in Zhejiang province were HEV-B.</p><p><b>CONCLUSION</b>The HEV-B was the main pathogen for viral meningoencephalitis in Zhejiang province in 2013, including 11 serotypes, while E7 was the first time to be isolated in Zhejiang province. The predominant isolates were CVB5 and E6 in southern and northern Zhejiang province respectively. The positive rate of viral nucleic acid detection was significantly higher than that of viral isolation. Regular EV isolation method was exposed to the risk of missing-detection of E9 and CVA9.</p>

Discussion on teaching reform of medical psychology in Chinese medicine institution / 中华医学教育探索杂志

There are Many gaps of medical psychology on course plans, teaching methods and examination methods in Chinese medicine institutions. Therefore, the teaching of medical psychology must be reformed. By improving course plans, strengthening multiple teaching methods and examination methods used, quality of teaching on medical psychology can be enhanced, and many persons with ability of traditional Chinese medical science can be educated to be abreast of bio-psycho-social medical model.

Investigation of the infection of Rotavirus in children in Hangzhou area / 中国基层医药

Objective To research the infection of Rotavirus in children in Hangzhou area and to get the message of the feature of epidemiology. Methods Stool specimens of 156 children with suspected acute viral enteritis in Hangzhou between September 2006 and January 2008 were collected. Rotavirus were detected for all specimens by enzyme linked immunosorbent assay(ELISA). Results Rotavirus was detected in 86 of 156(55. 1% ) specimens;all the 86 strains belonged to group A. The highest frequency of group A RV detected was 57% (70/123) in patients aged 6 ～ 24 months. Conclusion The major pathogen of acute viral enteritis in children in Hangzhou area between September 2006 and January 2008 was RV. Children under the age of 2 years seemed to be more susceptible to RV infection than those of other age groups. The symptoms of RV enteritis were more severe than those of other viral enteritis.