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Objective: The feasibility of the conduction system pacing (CSP) upgrade as an alternative modality to the traditional biventricular pacing (BiVP) upgrade in patients with pacemaker-induced cardiomyopathy (PICM) remains uncertain. This study sought to compare two modalities of CSP (His bundle pacing (HBP) and left bundle branch pacing (LBBP)) with BiVP and no upgrades in patients with pacing-induced cardiomyopathy.Methods: This retrospective analysis comprised consecutive patients who underwent either BiVP or CSP upgrade for PICM at the cardiac department from 2017 to 2021. Patients with a follow-up period exceeding 12 months were considered for the final analysis.Results: The final group of patients who underwent upgrades included 48 individuals: 11 with BiVP upgrades, 24 with HBP upgrades, and 13 with LBBP upgrades. Compared to the baseline data, there were significant improvements in cardiac performance at the last follow-up. After the upgrade, the QRS duration (127.81 ± 31.89 vs 177.08 ± 34.35 ms, p < 0.001), NYHA class (2.28 ± 0.70 vs 3.04 ± 0.54, p < 0.05), left ventricular end-diastolic diameter (LVEDD) (54.08 ± 4.80 vs 57.50 ± 4.85 mm, p < 0.05), and left ventricular ejection fraction (LVEF) (44.46% ± 6.39% vs 33.15% ± 5.25%, p < 0.001) were improved. There was a noticeable improvement in LVEF in the CSP group (32.15% ± 3.22% vs 44.95% ± 3.99% (p < 0.001)) and the BiVP group (33.90% ± 3.09% vs 40.83% ± 2.99% (p < 0.001)). The changes in QRS duration were more evident in CSP than in BiVP (56.65 ± 11.71 vs 34.67 ± 13.32, p < 0.001). Similarly, the changes in LVEF (12.8 ± 3.66 vs 6.93 ± 3.04, p < 0.001) and LVEDD (5.80 ± 1.71 vs 3.16 ± 1.35, p < 0.001) were greater in CSP than in BiVP. The changes in LVEDD (p = 0.549) and LVEF (p = 0.570) were similar in the LBBP and HBP groups. The threshold in LBBP was also lower than that in HBP (1.01 ± 0.43 vs 1.33 ± 0.32 V, p = 0.019).Conclusion: The improvement of clinical outcomes in CSP was more significant than in BiVP. CSP may be an alternative therapy to CRT for patients with PICM. LBBP would be a better choice than HBP due to its lower thresholds.

Objective·To investigate the correlation between intramuscular adipose tissue (IMAT) content and glucose metabolism in male patients with obesity.Methods·Eighty male patients with obesity were recruited from the Endocrinology Department of Renji Hospital, Shanghai Jiao Tong University School of Medicine from December 2019 to December 2020. According to the results of oral glucose tolerance test (OGTT), they were divided into normal glucose tolerance (NGT) group and impaired glucose regulation (IGR) group. General data and laboratory test indicators of the two groups were collected and compared. mDixon-Quant technique was used to measure the IMAT content in each skeletal muscle of the thigh in the two groups, and the proton density fat fractions (PDFF) of skeletal muscle in the two groups were compared. The multivariate Logistic regression model was used to analyze the independent influencing factors of IGR occurrence.Results·Compared with the NGT group, patients in the IGR group had a larger waist circumference (P=0.017), higher glutamic-pyruvic transaminase level, glutamic-oxaloacetic transaminase level, γ-glutamyl transferase (GGT) level, triacylglycerol (TAG) level, nonestesterified fatty acid (NEFA) level and sartorius PDFF (all P

Narrative therapy, as one of the psychological intervention modalities in humanistic medicine, has received increasing attention from scholars in various fields. This paper reviews the concept origin and development of narrative therapy, the application of narrative therapy in psychological interventions for cancer patients, and the advantages and limitations of narrative therapy, with the aim of providing a theoretical basis for clinical research on narrative therapy interventions for cancer patients. (叙事疗法是人文医学心理干预方式之一, 越来越受到各个领域学者的重视。本文从叙事疗法的概念起源及发展、叙事疗法在癌症患者心理干预中的应用、叙事疗法的优势与局限性3个方面进行综述, 以期为叙事疗法干预癌症患者心理情绪的临床研究提供理论基础。)

ABSTRACTHepatitis E virus (HEV) is a pathogen of global significance, but the value of HEV-related markers in the diagnosis of hepatitis E remains controversial. Previous studies on hepatitis E profiles have been mainly cross-sectional and conducted among inpatients in large hospitals, and hepatitis E cases have been primarily defined by limited partial markers. In this community-based study, 4,110 active hepatitis cases from a population of nearly 600,000 were followed over 48 months and serial serum samples were collected. Both HEV pathogen (HEV RNA and antigen) and anti-HEV antibody markers were used to determine HEV infection status and the relationship between hepatitis and HEV infection. In total, 98 hepatitis E patients were identified and all available isolates from 58 patients belonged to HEV genotype 4. The mean age of the patients was 58.14 years, with an overwhelming proportion of males (70.4%). Hepatitis E accounted for 22.86% of active hepatitis cases with alanine aminotransferase levels ≥15.0-fold the upper limit of normal, suggesting the need to include HEV in routine testing for these patients. Ninety-two hepatitis E patients were positive for at least 2 of HEV antigen, anti-HEV IgM, and HEV RNA markers at presentation, and 90.22% of them were positive for HEV antigen and anti-HEV IgM. HEV antigen, HEV RNA, and anti-HEV IgM positivity were observed in 89.80%, 82.65%, and 93.88% of hepatitis E patients at presentation, respectively. However, only 57.14% of anti-HEV IgM positivity occurred in hepatitis E patients. These findings will advance our understanding of hepatitis E and improve diagnosis.

Objective: We aimed to evaluate the feasibility and safety of his-bundle pacing (HBP) and left bundle branch pacing (LBBP) in patients with hypertrophic cardiomyopathy (HCM) and heart failure (HF). Methods: Patients with HF and interventricular septal thickness (IVST) ≥ 13 mm resulted from HCM, who accepted conduction system pacing (CSP) with a percentage of ventricular pacing > 40% from May 2018 to April 2022 were consecutively enrolled in our center. LBBP was preferred and HBP was the alternative therapy unless IVST ≥ 16 mm or LBBP failed, whereas LBBP would be the alternative therapy if HBP failed in patients with IVST ≥ 16 mm. All patients were followed up for at least one year. Data including clinical, echocardiographic parameters and electrocardiogram measurements, were collected and evaluated in patients with and without left ventricular ejection fraction (LVEF)

Background: The pathogen of angiostrongyliasis is the parasite Angiostrongylus cantonensis, and the transcriptome profiling of the male adult was unclear. We aimed to understand how the male adults adapt, so the expression profile of A. cantonensis adult males was analyzed. Methods: In order to improve the understanding of the transcriptome of adult males, RNA from three groups of male adult A. cantonensis was extracted and reverse transcribed to construct cDNA libraries. After sequencing, annotation of unigenes and transcripts was performed by querying the NR (Non-Redundant Protein Sequence Database), GO (Gene Ontology) and COG/ KOG (Clusters of Orthologous Groups of proteins/euKaryotic Ortholog Groups) databases. Results: For each group of adults, 43,260,894 raw reads and 43,200,341 clean reads were obtained. After successful assembly, 87,649 unigenes and 146,895 transcripts were obtained. Annotation of the unigenes and transcripts was identical and male adults expressed a series of genes encoding proteins specific to the male gender at the adult stage, such as proteins involved in energy metabolism, energy synthesis and transport. Expression of the ribosome pathway suggests a relationship with the physical activities during the adult male stage. Conclusion: The transcriptome analysis is a good reference to understand further the expression profile of male adult A. cantonensis.

Circulating subtypes of Influenza viruses seasonally change and therefore vaccines need to be matched to these strains each year, which is why there is a need for next-generation vaccines that can elicit broad and cross-type protection. Here, Li et al. generate a human-mouse chimeric antibody with broad neutralizing activity against seasonal and pandemic H1N1 and some H5N1 viruses in vivo and identify residues on hemagglutinin relevant for its broad neutralization activity.

Chronic hepatitis E virus (HEV) infection occurs mainly in immunosuppressed populations. We describe an investigation of chronic HEV infection of genotype 3a in an individual without evidence for immune deficiency who presented hepatitis with significant HEV viremia and viral shedding. We monitored HEV RNA in plasma and stools, and assessed anti-HEV specific immune responses. The patient was without apparent immunodeficiency based on quantified results of white blood cell, lymphocyte, neutrophilic granulocyte, CD3+ T cell, CD4+ T cell, and CD8+ T cell counts and CD4/CD8 ratio, as well as total serum IgG, IgM, and IgA, which were in the normal range. Despite HEV specific cellular response and strong humoral immunity being observed, viral shedding persisted up to 109 IU/mL. After treatment with ribavirin combined with interferon, the indicators of liver function in the patient returned to normal, accompanied by complete suppression and clearance of HEV. These results indicate that HEV chronicity can also occur in individuals without evidence of immunodeficiency.

This paper reviewed nursing management for a patient with erysipelas infection leads to sepsis combined with multiple organ dysfunction syndromes. A comprehensive treatment including anti-infective therapy, diuretic treatment, cardiac medication and circulation function treatment and related nursing management was carried out. Targeted nursing strategies including non-invasive ventilation nursing, medication care and fluid-management, fever nursing, catheter maintenance, skin care were carried out to ensure the therapeutic efficacy and symptom relieving. (本文总结1例丹毒感染致脓毒症合并多功能脏器衰竭患者的护理措施, 在给予抗感染、利尿、强心、维持循环功能治疗的同时还要加强护理, 从无创通气护理、用药监护及液体管理、发热护理、管路护理、皮肤护理等方面给予以针对性护理干预, 确保有效改善患者症状。)

Hepatitis E virus (HEV) is one of the most important public health issues around the world, and chronic HEV infection has been reported in immunosuppressed individuals. This study reported a male case, with very severe aplastic anemia (AA), who developed chronic hepatitis E after hematopoietic stem cell transplantation (HSCT). Abnormal alanine aminotransferase (ALT) appeared after HSCT and persisted for twenty-nine months. The case was seropositive for anti-HEV IgG and IgM after HSCT. Twenty-two months after HSCT, HEV RNA and antigen (Ag) testing were positive and persisted for five and seven months, respectively. Positive stains of HEV Ag were present in a liver biopsy sample. HEV Ag was present in bone marrow. The individual rapidly developed liver cirrhosis and was rescued by a regimen of oral ribavirin. These factors suggested there is a risk of HEV infection in HSCT recipients.

Given pandemic risks of zoonotic SARS-CoV-2 variants and other SARS-like coronaviruses in the future, it is valuable to perform studies on conserved antigenic sites to design universal SARS-like coronavirus vaccines. By using antibodies obtained from convalescent COVID-19 patients, we succeeded in functional comparison of conserved antigenic sites at multiple aspects with each other, and even with SARS-CoV-2 unique antigenic sites, which promotes the cognition of process of humoral immune response to the conserved antigenic sites. The conserved antigenic sites between SARS-CoV-2 and SARS-CoV can effectively induce affinity maturation of cross-binding antibodies, finally resulting in broadly neutralizing antibodies against multiple variants of concern, which provides an important basis for universal vaccine design, however they are subdominant, putatively due to their lower accessibility relative to SARS-CoV-2 unique antigenic sites. Furthermore, we preliminarily design RBDs to improve the immunogenicity of these conserved antigenic sites. Our study focusing on conserved antigenic sites provides insights for promoting the development of universal SARS-like coronavirus vaccines, thereby enhancing our pandemic preparedness.

The authors provide a comprehensive characterization of the human antibody response to a licensed hepatitis E virus (HEV) vaccine, Hecolin, in four individuals over the course of six months post vaccination. They demonstrate diverse patterns of antibody response underlying the vaccine protection.

Aiming at the problem of the failure of the downwind side gear teeth on the high-speed intermediate gear shaft of wind turbine gearbox，the fishbone analysis method is used to analyze the reasons of design，manufacture，material，assembly and operation maintenance. Based on the experimental research and simulation analysis method，it is determined that the failure of the gearbox is due to the lack of downwind direction in the assembly process of the gearbox. The control of bearing compression leads to the excessive clearance of bearings，which results in the eccentric load of axle gears.

Objective To study the detection rate of Streptococcus mutans in oral cavities of 3⁃5⁃year⁃old Han, Uygur and Mongolian children in Bortala Mongolian Autonomous Prefecture, and the correlation between genotype and dental caries of preschool children. Methods Ninety children were randomly selected from the sample bank of chil⁃ dren′s oral epidemiological survey data in the Bozhou area of Xinjiang. Forty⁃five children were included in the high caries group (more than 5 missing teeth), and 45 children were included in the noncaries group (0 missing teeth); each group comprised 15 children of each of the Han, Uygur and Mongolian nationalities. Plaque samples were collected and cultured with light saliva⁃bacillin agar medium and brain⁃heart infusion medium. Streptococcus mutans were cultured, and clinical isolates were further isolated and identified by Gram staining, biochemical identification and polymerase chain reaction. Genotype distribution was detected by random primer polymerase chain reaction. Results The detec⁃ tion rate of Streptococcus mutans in the 90 included children was 75.5%. The detection rate of Streptococcus mutans in the high caries group was 86.7%, which was significantly higher than that in the caries⁃free group (64.4%) (P＝0.014). There was no significant difference in the distribution of Streptococcus mutans among Han, Uygur and Mongolian nation⁃ alities (P＝0.457). A total of 549 clinical strains of Streptococcus mutans were obtained, and 113 different genotypes were found. In the high caries group, 61.5% carried more than one genotype of Streptococcus mutans, and 37.9% of the caries ⁃ free group had more than one genotype. The genetic polymorphism of Streptococcus mutans in the high caries group was significantly higher than that in the caries⁃free group (P＝0.035). Spearman correlation analysis showed that there was a positive correlation between oral Streptococcus mutans gene polymorphism and caries sensitivity (r＝0.258, P＝0.034). Conclusion The distribution of Streptococcus mutans in children′s oral cavity in the Bozhou area was dif⁃ ferent between the high caries group and the caries⁃free group, but there was no difference among nationalities. Strepto⁃ coccus mutans in the high caries group had more genotypes than those in the caries⁃free group. The genetic polymor⁃ phism of Streptococcus mutans might be related to the caries⁃causing ability of Streptococcus mutans.

Hepatitis E virus (HEV) is an important public health burden worldwide, causing approximately 20 million infections and 70,000 deaths annually. The viral capsid protein is encoded by open reading frame 2 (ORF2) of the HEV genome. Most ORF2 protein present in body fluids is the glycosylated secreted form of the protein (ORF2S). A recent study suggested that ORF2S is not necessary for the HEV life cycle. A previously reported efficient HEV cell culture system can be used to understand the origin and life cycle of ORF2S but is not sufficient for functional research. A more rapid and productive method for yielding ORF2S could help to study its antigenicity and immunogenicity. In this study, the ORF2S (tPA) expression construct was designed as a candidate tool. A set of representative anti-HEV monoclonal antibodies was further used to map the functional antigenic sites in the candidates. ORF2S (tPA) was used to study antigenicity and immunogenicity. Indirect ELISA revealed that ORF2S (tPA) was not antigenically identical to HEV 239 antigen (p239). The ORF2S-specific antibodies were successfully induced in one-dose-vaccinated BALB/c mice. The ORF2S-specific antibody response was detected in plasma from HEV-infected patients. Recombinant ORF2S (tPA) can act as a decoy to against B cells. Altogether, our study presents a design strategy for ORF2S expression and indicates that ORF2S (tPA) can be used for functional and structural studies of the HEV life cycle.

It was studied that the aquatic plant Acorus calamus and reed affected the enrichment ability of compound heavy metals (i. e. V, Cr and Cd) and physiological response and the two plants repair effects of polluted water were investigated by heavy metals. Results show that the tolerance index of two plants decreases with heavy metals concentration increasing in water body, whereas the growth of the Acorus calamus is better than that of reed. Under different concentrations of heavy metals, both Acorus calamus and reed show the strongest enrichment ability of Cd, followed by Cr, while the enrichment ability of V is relatively weak. Under same heavy metal concentration, Acorus calamus on the total enrichment quantities of three kinds of heavy metals are better than those of reed. When the mass concentration of heavy metal is 15 mg·L-1, the enrichment of three heavy metals by Acorus calamus is 1065.02, 1754.80 and 4372.40 mg·kg-1 for V, Cr and Cd, respectively. The enrichment index of Acorus calamus underground part of V, Cr and Cd is 2.1, 1.5 and 1.8 times better than that of reed. It is concluded that Acorus calamus is more suitable for the remediation of heavy metal pollution by V, Cr and Cd.

Fermentation has been considered as an effective way to improve the nutritional and sensory quality of food materials. In this paper, fermented wheat germ (FWG) was prepared by fermentation with Lactobacillus plantarum dy-1 and added as an ingredient in bread making for nutrition and quality improvement. The amounts ranged from 1 % to 6 % of FWG were added into ingredients for bread making, the similar amounts of raw wheat germ (RWG) were used as control, and the wheat flour without germ addition was used as blank. Then, bread quality was evaluated through nutrition, texture, and flavor analyses. The results showed that 4% of FWG addition had the ability to increase the specific volume, slow down the aging process, and improve the color and luster of bread. A significant increase in free amino acid content was observed in the FWG bread, which could be helpful to enrich the flavor substances in bread. The flavor analysis of bread showed that more volatile compounds mainly alcohols and aldehydes were present in FWG bread compared with RWG bread. In the fermentation process, the pH value was decreased and the total titratable acidity (TTA) was enhanced to inhibit the growth of microorganisms. Therefore, the addition of FWG could not only enhance its nutritional properties, but also improve the flavor, quality, and structural features of bread. Moreover, it exhibited a good availability to extend the shelf life of bread.