Objective To summarize the perioperative clinical care experience of parenteral and enteral nutrition supports in post-hepatectomy patients.Methods The clinical data of 146 consecutive post-hepatectomy patients in Beijing Hospital were collected and analyzed.For these patients,nutritional risk screening (NRS) 2002 was performed after admission,enteral nutrition support was provided before operation,and enteral and parenteral nutrition supports were provided after operation.Nutritional parameters,clinical outcomes,and nursing methods were evaluated.Results Among these 146 patients,91 patients had≥3 NRS2000 scores,and the remaining 55 patients scored ＜ 3.A total of 118 patients were administrated with enteral and pareteral nutrition;the average enferal nutrition time was 9.6 days,and the average pareteral nutrition time was 5.4 days.The average onset time of passage of gas by anus afar operation was (70.7±17.1) hours.Three patients died,15 patients suffered from infections after operation,and 13 patients experienced other complications.The median hospital stay was 25.5 days.Conclusions Post-hepatectomy patients need take nutritional risk screening after admission and receive appropriate nutritional supports in the perioperative period.It is equally important to strengthen clinical nursing for nutrition support.

Objective To investigate the nutritional risk,malnutrition rate,and nutritional support in elderly inpafients with hepatobiliary diseases.Methods Totally 156 eldedy inpatients(≥65 years)with hepatobiliary diseases were consecutively enrolled.Nutritional Risk Screening 2002(NRS 2002)was applied to screen nutritional risks on the next morning after admission and two weeks after admission or on the discharge day.Results Of 156 enrolled patients,151 patients(96.8%)completed the NRS 2002 screening.The nutrition risk and malnutrition rate were 36.9%(57/156)and 26.2%(41/156),respectively.The nutrition risk and malnutrition rate were significantly higher in patients with a hospital stay longer than 2 weeks than those with a hospital stay less than 2 weeks(49.6%and 36.7% vs.37.3%and 21.4%,respectively)(both P<0.05).In addition,100 patients(64.1%)with nutrition risk received nutrition support and 27 patients(17.3%)without nutrition risk received nutrition support.Among patients who had undergone major abdominal surgeries,137 patients(87.9%)with nutrition risk received nutrition support while 57 patients(36.8%)without nutrition risk received nutrition support.Conclusions NRS 2002 is a feasible nutritional risk screening tool for elderly inpatients with hepatobiliary diseases.A hospital stay more than 2 weeks the morbidity of the nutritional risk and malnutrition rate increased.Seems the value of nutritional support has not been well recognized in the department of hepatobiliary surgery,inappropriate application of nutritional support still exists.

Objective To investigate the feasibility of low dose dual phase contrast-enhanced chest CT with iterative mod el reconstruction (IMR) technique.Methods Totally 130 patients with suspected pulmonary occupying lesions underwent dual phase contrast-enhanced chest CT,who were randomly assigned into 2 groups (group A and group B,each n=65).Patients in group A were scanned with 100 kV,DoseRight technique with dose right index 10,and images were reconstructed with the hybrid iterative reconstruction (iDose4).While patients in group B were scanned with 80 kV,DoseRight technique with dose right index 8,and images were reconstructed with iterative model reconstruction (IMR).The objective image quality,subjective image scores and the excellence rate of vascular visualization were compared in both pulmonary artery (PA) and bronchial artery (BA) phases.The radiation dose was also calculated.Results The effective dose was (3.30 ±0.89)mSv in group A and (1.27 ±0.19)mSv in group B.Compared to group A,the effective dose reduced 61.52％ in group B (P＜0.001).Lower image noise and greater CNR were obtained in group B compared to group A in both PA and BA phases (all P＜0.001).No significant difference was found in subjective image scores of lung and mediastinal setting and the excellence rate of vascular visualization in both groups (all P＞0.05).Conclusion Using IMR,dual phase contrast-enhanced chest CT allows for a radiation dose reduction up to 61.52％,meanwhile,ensures the image quality and meets the diagnostic requirements.

Objective To observe clinical nurses′knowledge, attitude, and practice of evidence-based practice (EBP), and to explore its potential influencing factors, so as to provide targeted knowledge training for nurses.Methods The nurses′ information form and evidence-based practice questionnaire ( EBPQ) were used in this survey. Totally 140 nurses from a hospital in Beijing from June to July 2015 participated in this survey. Results The average score of practice, attitude, and knowledge on EBP were (22.94±7.32), (21.69±6.47) and (57.39±15.31). Statistically significant correlations were found among different nurses′ age, length of employment, educational background, job tittle and nurses′ practice, attitude, and knowledge score on EBP ( P<0.05) . Multivariate linear regression showed that the EBP of nurses was mainly decided by their knowledge level, attitude level, amount of literature reading, and endorsement related to EBP.Conclusions The status of nurses′knowledge and practice level related to EBP was low, and the attitude level was relatively positive. Knowledge training program should be established according to nurses′ age, length of employment, educational background, and job tittle, in order to raise the level of their knowledge, attitude and behavior on EBP. As well as the amount of literature reading and endorsement related to EBP are also primarily factors that influence the practice level.

Objective To evaluate the quality of evidence-based guidelines on senile functional constipation management and provide references for decision-making and the development of evidence-based guidelines suitable for China. Methods A search of Guideline International Network (GIN), National Guideline Clearinghouse (NGC), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Canadian Medical Association (CMA), New Zealand Guidelines Group (NZGG), Registered Nurses Association of Ontario (RNAO), National Health and Medical Research Council (NHMRC), American College of Gastroenterology (ACG), China Guideline Clearinghouse (CGC), Medlive website, and related websites and databases were conducted to screen the guidelines on senile functional constipation management with inclusion and exclusion criteria. Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) was applied on the methodological value evaluation for searched guidelines. The overall agreement among 3 appraisers was measured by the intraclass correlation coefficient (ICC). The analysis of advices from guidelines was performed. Results A total of 5 evidence-based guidelines were included, which were all from abroad. The average scores of guidelines in six domains of AGREE Ⅱ were 97.78% (scope and purpose), 78.52% (stakeholder involvement), 79.86% (rigor of development), 89.63% (clarity of presentations), 63.89% (applicability), and 86.87% (independence) respectively. The ICC were 0.887- 0.971. Considering the overall quality evaluation, 3 of them were grade A and 2 of them were grade B. The recommendations of included guidelines were almost consistent. Conclusions The overall quality of included guidelines is high. There is no local evidence-based guideline of senile functional constipation management in China. High-quality guidelines can offer the evidence support for the development of clinical practical guideline for senile functional constipation management. Foreign guidelines should be localized before their application in the clinic in China.

An ever increasing number of drugs directed as epidermal growth factor receptor tyrosine kinase inhibi-tor (EGFR-TKI) bring a new revolution for non-small cell lung cancer (NSCLC) therapy, and many large scales of studies show that only people with EGFR-sensitive mutation can benefit from these drugs. The main method of EGFR mutation detection is to analyze the DNA sequence of EGFR, which can be the lung cancer tissue, pleural fluid tumor cells, circulating tumor cells and peripheral blood free DNA obtained by surgery or puncture, the biggest drawback is that the heterogeneity of EGFR muta-tion cannot be analyzed. However, with the development of molecular imaging, the development of EGFR-targeted molecular probes based on positron emission computed tomography-computed tomography (PET-CT) has made it possible to reveal the EGFR mutations in lung cancer tissues in vivo, and can detect the heterogeneity of EGFR mutations. This article reviews all the results and progress of molecular probes targeting EGFR mutations.

OBJECTIVE: To assess the value of non-invasive prenatal testing (NIPT) for the identification of numerical and structural chromosomal abnormalities and copy number variations (CNVs) in fetuses. METHODS: 46 197 pregnant women undergoing NIPT at the Prenatal Diagnosis Center of Chenzhou First People's Hospital from January 2018 to December 2021 were selected as the study subjects. Positive cases were subjected to chromosomal karyotyping and copy number variation sequencing (CNV-seq) following amniocentesis. RESULTS: Nearly 50% of common chromosomal aneuploidies were found in the elder pregnant women. Among these, sex chromosome aneuploidies were mainly found in pregnant women with advanced age as well as borderline risks by serological screening. Rare autosomal aneuploidies and CNVs were mainly found in those with borderline or high risks by serological screening. The positive predictive values (PPV) for fetal chromosomal abnormalities indicated by NIPT were as follows: T21 (92.37%, 109/118), T18 (53.85%, 14/26), sex chromosome aneuploidies (45.04%, 59/131), T13 (34.62%, 9/26), CNVs (29.17%, 14/48), and rare autosomal aneuploidies (2.60%, 2/77). CONCLUSION NIPT has a high detection rate for T21, T18, T13 and sex chromosome aneuploidies. It can also detect rare autosomal aneuploidies and CNVs, including some rare structural abnormalities, though verification is required by analyzing amniotic fluid samples.
Pregnancy ; Female ; Humans ; DNA Copy Number Variations ; Chromosome Aberrations ; Chromosome Disorders/genetics* ; Aneuploidy ; Fetus

This paper summarizes the current situation and necessity of the training of traditional Chinese medicine (TCM) nursing specialists in China, as well as the existing achievements and existing problems, and puts forward the prospects and suggestions for the training of TCM nursing team, so as to strengthen the construction of TCM nursing culture, build a high-quality TCM nursing talent team, and promote the high-quality development of TCM nursing.

Objective:To explore the gap between the clinical nursing status and practice guidelines of elderly functional constipation, propose corresponding action strategies, and provide reference for the clinical transformation of the guidelines.Methods:From July to October 2019, totally 330 clinical nurses and nursing managers of elderly patients with functional constipation admitted into the general hospitals, hospitals of traditional Chinese medicine, and hospitals of traditional Chinese medicine and western medicine in Beijing were selected by convenient sampling and investigated with self-made questionnaires. The standard and algorithm of recommendations were formulated, and Excel software was used to calculate the compliance rate, partial compliance rate, and non-compliant rate of recommendations. A total of 330 questionnaires were distributed in this study, and 330 questionnaires were recovered, with a recovery rate of 100.0% (330/330) . After excluding invalid questionnaires such as items with missing values greater than 10% and all items having the same answers, there were 317 valid questionnaires, with an effective rate of 96.1% (317/330) .Results:Among the recommendations of the 12 guidelines, the 3 items with the highest compliance rate were health education related to toileting patterns, health education related to activities and sports, satisfaction and effect evaluation, while the 4 items with the highest non-compliance rates were building interdisciplinary teams, comprehensive education and program promotion, health assessment, and physical examination of medication history. There was a statistically significant difference in the clinical practice status between nurses who had and had not received relevant training ( P<0.01) . Conclusions:Most nurses can provide comprehensive care for elderly patients with functional constipation, but there is a big gap between the practice and the guidelines. Measures such as strengthening nurse training and talent training and standardizing the nursing process of constipation can help promote the clinical translation of evidence.

Objective: To investigate the effect of miR-124 on the invasion and migration of esophageal cancer KYSE170 cells by regulating autophagy. Methods: miR-124 mimic was transfected into esophageal cancer KYSE170 cells. Transwell assay was used to detect the change of invasion and migration ability of cells. Dual luciferase reporter gene assay was used to verify the targeted regulation of BECN1 (Beclin1) by miR-124, and Western blotting was used to analyze the expressions of BECN1, P62 and LC3 protein. siRNA targeting BECN1 was transfeted into KYSE170 cells, and then the cell invasion and migration ability was calculated by Transwell assay. The expressions of BECN1, P62 and LC3 protein were detected by Western blotting. miR-124 mimic and BECN1 over-expression plasmid were co-transfected into KYSE170 cells, and then Transwell assay was used to detect the changes of cell invasion and migration ability, and Western blotting to examine the expression levels of autophagy-related gene. Results: The invasion and migration ability of KYSE170 cells were significantly inhibited after transfection with miR-124 mimic (All P<0.05). The expression of autophagyrelated protein P62 was increased, and the expression of BECN1 and LC3 was significantly decreased (All P<0.01); in addition, the activity of luciferase reporter gene was also significantly reduced (P<0.01). Silencing BECN1 expression inhibited the invasion and migration of esophageal cancer KYSE170 cells (P<0.01). However, after co-transfection with BECN1 over-expression plasmids, the effects of miR-124 mimic on the autophagy, invasion and migration of esophageal carcinoma KYSE170 cells were significantly weakened (P<0.01), it was also accompanied with lower P62 expression, and higher LC3 expression (P<0.01). Conclusion: miR-124 mimic can inhibit the invasion and migration of esophageal carcinoma cells. The mechanism may be related to the autophagy-related gene BECN1 expression.