Objective To examine the psychometric characteristics of the Neonatal Oral-motor Assessment Scale (NOMAS) and the influence of evaluation time on assessment results of oral motor skills for preterm infants,and to provide advice for the application of oral-motor assessment in clinic practice.Methods Following Palmer's method,a video recording was made for the preterm infants at different age during the first 2 min of nutritive sucking(NS).We stored the recordings on a digital videodisc and two NOMAS assessors assessed each recording.Results The NOMAS had acceptable internal consistency for less than 35 weeks' PMA (postmenstrual age).Moderate correlation were found between scores on the NOMAS and feeding performance for less than 35 weeks' PMA (normal sucking r=0.58,sucking disorder r=-0.61).The NOMAS demonstrated low responsiveness to changes in oral-motor skill in a week period,ranging from 33 to 36 weeks' PMA (SRM=0.02～0.49).The NOMAS scores for evaluating 30 seconds and 2 minutes were not consistent,the former scores was higher.Conclusions The reliability and validity of NOMAS were acceptable in assessing the oral-motor function of preterm infants for less than 35 weeks' PMA.The evaluation time of NOMAS was suitable for 2 min.

Objectives To investigate the expression features and roles of the costimulatory molecules and T lymphocyte subsets from patients with chronic nephritis.Methods The expression of the costimulatory molecules CD 28 and CD 137 on PBMC (peripheral blood mononuclear cells) and T lymphocyte subsets from 52 patients with chronic nephritis were studied by immunophenotyping and flow cytometry analysis.Results The T lymphocyte subsets from patients with chronic nephritis showed an obvious imbalance with reversing CD 4/CD 8 ratio,decreasing CD + 4T cells and increasing CD + 8T cells.The expression of the costimulatory molecule CD 28 on T cells was significantly lower compared with normal controls (P

Objective To define the mechanical features of mitral annulus at various sites,and to investigate the specific mechanics characterization at different mitral annulus sites in evaluation consequences of left ventricular function by dual pulse-wave Doppler (DPW) technology.Methods The DPW spectrums were obtained at lateral and aboral interval,anterior and inferior and posterior mitral annular from 112 normal adults.The peak systolic velocity (Sm),peak early diastolic velocity (Em),peak late diastolic velocity (Am),the beginning time of the peak and the time to peak were measured,and E/A,Em/Am,E/Em,left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were computed.Results 1)Sm,Em,Am and Em/Am measured in the free wall annulus were significantly greater than measured in the interval annulus of mitral annular sites.However,E/Em was opposited (P ＜ 0.05).Sm of the posterior wall mitral annulus accelerated frist and experienced shortest duration in all the mitral annular sites (P ＜ 0.01).There were no significant differences of Em time parameters among different mitral annulus sites.Am of the beginning time and peak time in the free wall annulus were significantly longer than that in the interval annulus of anterior mitral annular sites.However,the acceleration time was opposited(P ＜0.05).2) Sm was correlated with LVEF and LVFS (r =0.243 and r =0.227,P ＜0.01) only at the posterior mitral annular site,Em/Am of anterior and posterior wall mitral annulus had the highest correlations with mitral orifice flow E/A(r =0.545 and 0.545 respectively,P ＜ 0.01).Conclusions There are significant differences among the mechanics patterns at different mitral annulus sites in normal adults.The mechanics characterization at different mitral annulus sites have different conclusions of left ventricular function.

Objective To investigate the distribution of critical values of adults in Beijing, to provide the evidence for the formulation of the Standardized Management Guideline in Critical Values, in order to promote the accurate management of critical values.Methods A total of 110 398 data of critical values from the tertiary and above medical institutions during January 1 to May 31 in 2015 in Beijing were collected by the way of on-site inspection, covering the disciplines of hematology, clinical chemistry, coagulation and blood gas analysis.Fristly, the selected critical values were classified by the factor of admission departments and disease types,then were analyzed by using Kruskal-Wallis test, to compare the differences in each group.Secondly,the combined groups were classified by the factor of gender then were analyzed by using Mann-Whithey U test, to compare the differences in each group.Finally, the stratification thresholds of critical values were established.Results Except for the upper limits of Ca, pH, pCO2, Hb and the lower limits of Glu, pH, the rest of thresholds of critical values had significant differences due to different admission departments and disease types and/or gender.Conclusion Depending on the different admission departmentsces disease types and/or gender, hierarchical limit values on each critical value were formulated.

OBJECTIVE: To evaluate the long-term efficacy and safety of nevirapine (NVP)-based regimens for HIV-infected Chinese patients in routine clinical practice. METHODS: From October 2002 to May 2004, 57 HIV-1-infected patients commenced highly active antiretroviral therapy (HAART), and were followed to December 2008. They originally received 2 nucleoside reverse transcriptase inhibitors (NRTIs) and nevirapine. HIV RNA levels, T lymphocyte subsets and safety were assessed. Blood routine test and main laboratory parameter changes were traced. If apparent side effects or virological failure appeared we would, if necessary, terminate the therapy or change the regimen. RESULTS: Of the 57 subjects, 34 were followed-up for more than 4 years. After 5-6 years, 63.3% of the subjects (19/30) had HIV RNA levels<50 copies/microL, and the median increase in CD4(+) cell count from the baseline was 329 cells/microL. The mean decrease in CD8(+) cell count was 128 cells/microL. At the same time, the CD4(+) CD45RA+CD62L cell count and CD4(+)CD45RO(+) cell gradually increased, and the counts of CD8(+)CD38(+) cell declined gradually. These changes are apparent 2 years after HAART. The increase rate slowed down after 2 years. But they did not recover completely as well as healthy people at year 6. About 56% (32/57) of HIV-infected patients developed various drug-related side effects. The most common was gastrointestinal side effect, followed nervous disorder, baldness, and rashes, mostly happened in 6 months. Gamma-GT increased occurred in 29.8% of patients (17/57), and serum cholesterol and triglyceride elevated in 26.3% of the patients (15/57). Six patients developed lipodystrophy, mainly in female patients, and 25 patients showed abnormal blood picture and liver function, renal function changes and amylase elevation. Grade 3-4 adverse events occurred in 3 cases (2 peripheral neuropathy, and 1 suspected lactic acidosis). One subject experienced grade 3 rashes. CONCLUSION Antiretroviral therapy with NVP-based regimens is safe and effective by suppressing HIV viremia and producing continued CD4 cell increases in subjects with HIV or AIDS for 6 years.
Adult ; Anti-HIV Agents ; administration & dosage ; adverse effects ; Antiretroviral Therapy, Highly Active ; adverse effects ; methods ; CD4 Lymphocyte Count ; China ; Didanosine ; administration & dosage ; adverse effects ; Female ; Follow-Up Studies ; HIV Infections ; drug therapy ; virology ; HIV-1 ; drug effects ; isolation & purification ; Humans ; Male ; Middle Aged ; Nevirapine ; administration & dosage ; adverse effects ; Reverse Transcriptase Inhibitors ; administration & dosage ; adverse effects ; Stavudine ; administration & dosage ; adverse effects ; Treatment Outcome ; Viral Load ; Young Adult

Objective To investigate the prevalence of restless legs syndrome (RLS) in peritoneal dialysis patients and analyze the related risk factors.Methods This study was a cross-sectional study.The patients receiving maintenance peritoneal dialysis from January 2017 to December 2017 in the Peritoneal Dialysis Center of the Second Hospital Affiliated to Soochow University were selected as the study subjects.RLS was screened for peritoneal dialysis patients by epidemiological field investigation based on the RLS diagnostic criteria of the International Restless Leg Syndrome Research Group in 2014.Clinical data and laboratory examinations of selected patients were collected and the differences of clinical indicators between RLS and non-RLS patients were compared.The risk factors related to RLS were analyzed by logistic regression.Results Seventy-six cases of RLS were screened out from 396 PD patients.The prevalence of RLS was 19.2％.Compared with non-RLS group,RLS group patients had longer dialysis age,less 24 hours urine volume,and elevated blood intact Parathormone (iPTH) and alkaline phosphatase (AKP) (all P ＜ 0.05).There was no significant difference in primary disease ratio,sex,age,body mass index,blood pressure,hemoglobin,creatinine,urea nitrogen,uric acid,ferritin,serum iron,transferrin saturation,blood calcium,blood phosphorus,total cholesterol,triglyceride,low density lipoprotein,high density lipoprotein,eGFR,Kt/V,Ccr between RLS and non-RLS group patients (all P ＞ 0.05).Multivariate logistic regression analysis showed that long dialysis age (OR=1.010,95％CI 1.001-1.018,P=0.022) and high blood AKP (OR=1.005,95％CI 1.001-1.010,P=0.021) were independent risk factors for RLS in peritoneal dialysis patients (both P ＜ 0.05).Conclusions The prevalence of RLS is high in peritoneal dialysis patients.Long dialysis age and high blood AKP are independent risk factors for RLS.

Objectives:To analyze the consistency of evaluating left ventricular hemodynamics (HDF) based on single plane and multi plane cine sequences of magnetic resonance mitral valve orifice.Methods:A prospective study was conducted on 48 healthy adults, and two methods were used to measure the mitral valve diameter and calculate HDF parameters. The first method was to measure the diameter of the mitral valve opening in the left ventricular three chamber cine sequence; The second method is to measure the mitral valve diameter using cine sequences of two chamber, three chamber, and four chamber hearts, and then take the average value. Paired t-tests were used to compare the differences in HDF measured by two methods, and Pearson correlation coefficient ( r), intra group correlation coefficient ( ICC), and Bland-Altman analysis were used to test the consistency and reproducibility of the two methods. Results:The root mean square (RMS) of longitudinal HDF calculated using single plane and multi plane mitral valve diameters were [(17.28±4.41)% vs (17.21±4.61)%] ( P=0.379) for the entire cardiac cycle, [(21.45±5.54)% vs (21.49±5.68)%] ( P=0.646) for systolic phase, and [(12.78±4.10)% vs (12.54±4.24)%] ( P=0.106) for diastolic phase, respectively. The difference in the calculation results of HDF parameters related to ventricular function was not statistically significant (all P>0.05), and there was good consistency ( r=0.924-0.996, ICC=0.924-0.995). The two HDF parameters related to atrial function were sensitive to the measurement method of mitral valve orifice diameter [RMS of longitudinal HDF during active atrial emptying: (3.26±1.51)% vs (3.32±1.55)%, P=0.006; longitudinal HDF pulse during active atrial emptying: (-2.60±1.28)% vs (-2.76±1.30)%, P<0.001]. Conclusions:The ventricular function related HDF parameters obtained from the analysis of mitral valve orifice diameter using single plane and multi plane methods have good consistency, and can be evaluated using relatively simple single plane methods for left ventricular HDF.

Objective To evaluate the reliability of children anthropometric indicators measured by medical students in clini-cal practice .Methods The convenient sampling was adopted to collect the data of the head circumference (HC) ,recumbent length (RL) and crown-rump length (CRL) of infants and young children measured by the students in clinical practice from entering-de-partment training to exiting-department .The re-measured data by clinical teachers were simultaneously collected .The measurement difference were compared between the students and clinical teachers .The measurements reliability was described by using the indi-cators such as the mean absolute differences (MAD) ,percentages of difference within a critical value (PDCV) and so on .Results MAD of HC ,RL and CRL at entering-department were 0 .46 ,0 .55 ,0 .81 cm respectively ,which at exiting-department were 0 .30 , 0 .43 ,0 .51 cm respectively ,the difference were statistically significant (P<0 .05) .PDCV of HC ,RL and CRL belonging to good quality standard at entering-department were 41 .5% ,58 .0% and 36 .0% respectively ,which at exiting-department were increased to 53 .5% ,70 .0% and 59 .0% respectively .PDCV of HC ,RL and CRL belonging to error data were 19 .0% ,10 .0% and 13 .0% re-spectively .Conclusion RL measured by medical students in clinical practice has good quality ,while the bigger errors exist in the measurement values of HC and CRL .

Objective:To develop an occupational stress management system for medical staff, in order to provide scientific reference for management actions.Methods:From January 2019 to July 2020, a stress management system initially took shape based on employee assistant program(EAP)and the assessment-prevention-control-evaluation organizational stress management model, pinpointing pediatrics featuring high occupational stress as the breakthrough point. Other means called into play include literature review and semi-structured interviews of pediatric managers and staff, for the purposes of learning the status of stress management. Delphi method was also used to learn by correspondence the occupational stress management system as seen by pediatric experts. The weight of items was determined by percentage method.Results:Eight managers and eight pediatric staff were interviewed, with four topics identified. Twenty experts participated in 2 rounds of Delphi inquiry by correspondence, and the recovery rates were 91% and 100% respectively. The authority coefficients were 0.78 and 0.80, and the Kendall coordination coefficients were 0.17 and 0.14(both P<0.01). The finalized occupational stress management system consists of 5 level-1 indicators, including organization system, stress assessment, stress prevention, stress control and effect evaluation, as well as 21 level-2 indicators and 71 level-3 indicators. Conclusions:The occupational stress management system of medical staff is scientific, reliable and comprehensive, serving as a useful reference for the hospital management in their occupational stress management work.

Objective To analyze the correlation of family function with parenting self-efficacy (PSE) in autism spectrum disorder (ASD) family. Methods Cohort study was carried out. From August, 2015 to February, 2016, caregivers of ASD children (n=142) and healthy children (n=131) were enrolled into investigation group (n=173) and control group (n=131). They were assessed with Family Assessment Device (FAD) and Tool to Measure Parenting Self-efficacy (TOPSE). Results There were significant differences in the scores of FAD and TOPSE between two groups (P<0.05). The scores of FAD were lower in the high income, urban ASD families than in the low income, rural ASD families (P<0.05). The scores of FAD negatively correlated with the scores of TOPSE in the ASD families (r=-0.152 to -0.257, P<0.05). Conclusion The family function and level of PSE of the ASD families was obviously inferior to the healthy families, and the worse the family function is, the lower the level of PSE will be. Individualized and family-centered intervention strategies should be developed to provide a good family environment for the rehabilitation of children with ASD.