Objective T o observe and analyze the confirm ed cases of paternity testing, and to explore the m utation rules of ST R loci. Methods T he m utant ST R loci w ere screened from 20723 confirm ed cases of paternity testing by G oldeneye 20A system .T he m utation rates, and the sources, fragm ent length, steps and increased or decreased repeat sequences of m utant alleles w ere counted for the analysis of the characteristics of m utation-related factors. Results A total of 548 m utations w ere found on 19 ST R loci, and 557 m utation events w ere observed. T he loci m utation rate w as 0.07‰-2.23‰. T he ratio of pater-nal to m aternal m utant events w as 3.06:1. O ne step m utation w as the m ain m utation, and the num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences. T he repeat se-quences w ere m ore likely to decrease in tw o steps m utation and above. M utation m ainly occurred in the m edium allele, and the num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences. In long allele m utations, the decreased repeat sequences w ere significantly m ore than the increased repeat sequences. T he num ber of the increased repeat sequences w as alm ost the sam e as the decreased repeat sequences in paternal m utation, w hile the decreased repeat sequences w ere m ore than the increased in m aternal m utation. Conclusion T here are significant differences in the m utation rate of each locus. W hen one or tw o loci do not conform to the genetic law , other detection system should be added, and PI value should be calculated com bined w ith the inform ation of the m utate ST R loci in order to further clarify the identification opinions.

A HPLC method for simultaneous determination of uridine, inosine, guanosine, adenosine and cordycepine
in Cordyceps sinensis was developed. The sample solution was prepared with 0.5% phosphoric acid solution by ultrasonic extraction. The separation was performed on a ZORBAX SB-AQ (150 mmí4.6 mm, 5 μm)column with gradient elution by 0.1% formic acid solution and acetonitrile, with column temperature 30℃, at a flow rate of 0.8 mL/min, and detected at wavelength of 260 nm. The result of method validation showed that the developed method had high accuracy and good repeatability. This method has been successfully applied for analysis of 5 kinds of nucleosides in different parts of C. sinensis. The results indicated that content of nucleosides in stroma is higher than that in insect body and whole C. sinensis.

Pathologic experiment teaching is special feature and stresses morphologic teaching,It is easy for stuents to learn passively.Problem-basedlearning ( PBL ) was introduced in pathologic experiment teaching in eight-year clinical medicine.program courses.In pathologic experiment class,questions was produced by analyzing various diseases,observing macroscopic and microscopic changes,discussed by clinical cases and solved by students themselves with bilingualistic teaching.In conclusion,PBL was significant in improving the quality of pathological experiment teaching,overcoming the shortage of morphologic learning,and making students more active in learning pathology.

Objective We reported the rehabilitative nursing points of patients with pectoralis minor muscle transplantation for recovery of thumb oppositional function. Methods We selected 10 patients who underwent pectoralis minor muscle transplantation for recovery of thumb oppositional function and gave them perfect preoperative examination and psychological nursing. We also implemented rigorous monitoring postoperation and auxiliary electric stimulation and functional exercises. The emphasis was put on the exercise of thumb oppositional function. Results The thumb oppositional function of all the ten patients recovered. The myodynamia reached level 4 and the shape of thenar was satisfying after 6 to 12 months of follow-up visit. Conclusions Sufficient preoperative psychological nursing and effective postoperative rehabilitative treatment had pivotal significance for the success of operation and the recovery of thumb oppositional function.

Objective:To establish and evaluate the effect of graded training mode of clinical nutrition nursing in general hospital.Methods:A clinical nutrition nursing group was established, including core management group, quality control group, education and training group and liaison nurse group. Hierarchical training and practice of clinical nutrition nursing was conducted throughout the hospital, and effect of training was evaluated.Results:The nurses' nutrition knowledge increased from (66.60±9.72) to (85.06±7.85) points, nutrition attitude increased from (72.38±5.55) to (92.50±5.10) points, nutrition behavior increased from (66.87 ± 6.83) to (88.76 ± 7.60) points, and the differences were statistically significant ( t values were -15.520, -11.128, -12.238, P<0.01). The nutritional risk screening rate and nutritional intervention rate of patients were improved to 100%, and the academic level of nurses in nutritional nursing was further improved. Conclusion:The application of graded training mode of clinical nutrition nursing can improve nurses' nutritional knowledge and skills, improve nurses' professional and academic level, and improve patient clinical outcomes.

Objective:To evaluate the effect of early screening and multidisciplinary management for elderly patients with dysphagia.Methods:All of the elderly patients who were hospitalized during January 2018 to December 2019, were divided into control group ( n=16 273) and intervention group ( n=18 853) according to the order of inpatient. Patients in control group received routine care, and those in intervention group received early screening and multidisciplinary management. The difference of detection, rehabilitation, indwelling, pneumonia and the professional level of nurses were compared between two groups. Results:The positive rate of intervention group was 14.10% (2 659/18 853), which was higher than 10.81% (1 759/16 273) of control group ( χ2 value was 66.11, P<0.01). The rehabilitation rate was increase from 67.08% (1 180/1 759) to 78.68% (2 092/2 659) ( χ2 value was 17.88, P<0.01) . The rate of indwelling nasogastric tube was decreased from 21.49% (378/1 759) to 19.33% (514/2 659) ( χ2 value was 8.52, P<0.01). The incidence of pneumonia was decreased from 10.18% (179/1 759) to 4.25% (113/2 659) ( χ2 value was 37.27, P<0.01). And dysphagia related knowledge ( t value was 7.549, P<0.01) and skills ( t value was 7.413, P<0.01) of the nurses were improved. Conclusion:Implementation of early screening and hierarchical management based on the form of multidisciplinary cooperation for dysphagia in elderly inpatients can enhance the positive outcome of patient and improve dysphagia related knowledge and skills of nurse.

Objective:To study the intervention effect of narrative nursing on parent-child conflict in patients with chronic viral hepatitis b complicated with epilepsy.Methods:In 1 case because of parent-child conflicts caused by frequent attacks, depression, and anorexia behavior of chronic hepatitis b patients with viral hepatitis with epilepsy care process, the application of narrative postmodernism theory model of nursing and the nursing of the five core technologies: somatization, rewrite, restore, definition file, ceremony and treatment during the stay in hospital for patients and their parents were conducted three narrative counseling, two telephone follow-up after discharge, psychological intervention to the parent-child conflict problem.Results:Through narrative psychological intervention, no epileptic seizures caused by parent-child conflict occurred, depression was relieved, and no anorexia behavior was observed.Conclusion:Narrative nursing can help to solve the parent-child conflict between patients and their parents and promote physical and mental recovery.

Objective:To evaluate the reliability and validity of the Chinese version of the Ohkuma questionnaire.Methods:The Ohkuma questionnaire was translated and revised, before it was used to investigate 70 elderly patients. Cronbach′s alpha coefficient, Cohen′s kappa coefficient and Pearson correlation were used to evaluate the scale′s internal reliability, sub-item retest reliability and total score retest reliability. KMO and Bartlett tests were used to evaluate the validity. The correlation between the Chinese version of the Ohkuma questionnaire and ratings from video fluoroscopy before and after treatment was used to evaluate the scale′s discrimination ability.Results:The Cronbach′s alpha of the Chinese version of Ohkuma questionnaire was 0.831, with 0.814 in the initial evaluation and 0.808 in a second evaluation. The Cohen′s kappas of the 15 sub-items ranged from 0.728 to 1.000. The Pearson correlation coefficient of the total score was 0.914. The scale′s KMO value was 0.701. A t-test of the Ohkuma scores before and after treatment showed a statistically significant difference.Conclusion:The revised Chinese Ohkuma questionnaire has good reliability, validity and discriminatory power. It can be used to screen for dysphagia among the elderly.

Objective:To investigate the possible role of non-invasive fibrosis scoring systems for detecting high-risk plaque among patients with non-alcoholic fatty liver disease (NAFLD).Methods:A total of 477 consecutive asymptomatic subjects underwent a health checkup including coronary computed tomography angiography (CTA) and abdominal ultrasonography. Fatty liver was evaluated using ultrasonography, and the NAFLD fibrosis score (NFS) was calculated. Coronary stenosis and plaque were evaluated using coronary CTA.Results:Of the study population, 223 had NAFLD. Among the NAFLD patients, high-risk coronary plaque was more frequent in patients with high or intermediate NFS than those with low NFS (62.5% versus 24.0%, P<0.001). The adjusted odds ratio with 95% confidence interval of high-risk plaque was 3.24 (1.11-9.40) for the highest versus lowest quartile of NFS ( P=0.016). Among those without NAFLD, NFS was not associated with high-risk coronary plaque (C-statistic with NFS versus without NFS, 0.766 versus 0.764, P=0.715). Adding NFS to the traditional cardiovascular disease (CVD) risk model increased the C-statistics by 0.679 to 0.739 ( P=0.031). Conclusions:There was an independent association of NFS with high-risk coronary plaque in patients with NAFLD, suggesting its potential use to optimize management of patients with NAFLD.

Objective To investigate surgical treatment and nursing of upper extremity arterial occlusive disease.Methods A total of 12 patients with upper extremity arterial occlusive disease from January 2001 to November 2014 in our hospital were treated by vascular transplantation. Patients received comprehensive preoperative examination,careful postoperative observation and specialist nursing.Nursing interventions were summarized with retrospective analysis.Results Patients after revascularization were followed up for 1 to 2 years.Graft vascular patency,hands ulcer healing and blood supply restoration were satisfied with effects.Conclusions The effects are satisfied after autologous vascular transplantation and artificial vascular transplantation work impressively on vascular reconstruction in patients with upper extremity arterial occlusive disease. Comprehensive preoperative examination, careful postoperative observation and nursing play an important role in the success of the surgery.