Objective To investigate the correlation between burdens of main caregivers of patients undergoing enterostomy and social supports.Method Fifty eight caregivers of patients with enterostomy involved the investigation by using questionnaires of Zarit Caregiver Burden Interview and Social Support Rating Scale.Results The mean score of burdens was(21.10±14.17).The total score of social supports was(43.69±8.61),higher than the national norm(34.56±3.73)(P<0.05).The total score of burdens, personal burdens and responsibility burdens were all negatively correlated with social support(P<0.01 for all).Conclusion The higher social support,the lower care burdens.The doctors and nurses should help the patients and their families to establish more accesses to the social supports so that the caregivers relieved and stress and reduce the burdens.

Objective To assess if evaluating with Peabody's fine motor development scale with 4 degree grading is more sensitive than with 3 degree grading, and whether or not it is feasible to evaluate by quantization with monthly averages. Methods A total of 864 normal children aged 1 month to 60 months were evaluated with the Peabody scale using 4 degree grading and 3 degree grading. The development results were averaged by month to express the development. Results Both ways, the monthly averages of children 4-9 months old were higher than the others. The values obtained with 4 degree grading were lower than those with 3 degree grading in each functional area, and the difference was more obvious with increasing age, but the differences were not statistically significant. With 3 degree grading the total score was equal to the actual score after the age of 9 months, but with 4 degree grading this was not true until at least 18 months. Conclusions Evaluating with Peabody's fine motor scale with 4 degree grading and quantization using monthly averages is reliable and more sensitive than 3 degree grading.

Objective To evaluate the effects of the comprehensive psychological intervention on anxiety and depression of the patients with breast cancer during chemotherapy ,and to explore the influence of depression and anxiety before and after chemother-apy on the cellular immune function .Methods A total of 81 married female patients with breast cancer were surveyed and assessed with self-designed questionnaire ,the Herth Hope Scale ,the Hamilton Depression Scale(HAMD) and the Hamilton Anxiety Scale (HAMA) .64 cases of breast cancer with depression and anxiety according with the included standards (HAMD scores ≥8 and HA-MA scores ≥7) were randomly divided into the intervention group(n=32) and the control group(n=32) .The levels of T lympho-cyte subsets(CD3+ ,CD4+ ,CD8+ ,CD4+ /CD8+ ) and the natural killing(NK) cells in peripheral venous blood were determined by the flow cytometry(FCM) .Results The Herth scores after chemotherapy in the intervention group were increased by 37 .19% than that of the control group ,while the HAMD scores were decreased by 36 .01% compared with the control group ,the differences be-tween them showing statistical significance (P<0 .01) .In the comparison between before and after chemotherapy ,the Herth scores in the intervention group were increased by 12 .57 ± 4 .57 ,while the HAMD and HAMA scores were declined by 9 .32 ± 1 .86 and 4 .35 ± 1 .15 respectively ,the differences showed the statistical significance (P< 0 .01) .Compared with the control group ,CD3+ , CD4+ ,CD4+ /CD8+ ratio and NK cells before and after chemotherapy in the intervention group were increased by 2 .10 ± 1 .63 , 1 .51 ± 1 .02 ,0 .05 ± 0 .02 and 0 .78 ± 0 .52 correspondingly ,the differences among them had statistical significance(P<0 .001) .The HAMD scores were negatively correlated with the CD4+ /CD8+ ratio(r= -0 .554) .Conclusion The cellular immune hypofunction in the patients with breast cancer is probably related with anxiety and degree of depression .The comprehensive psychological inter-vention model can improve the anxiety and depression mood during chemotherapy .

Objective To explore the clinical characteristics of renal transplantation in patients with diabetes mellitus (DM)-induced end-stage nephropathy.Methods The clinical data of 408 cases who underwent renal transplantation in our center from 2009 to 2013 were retrospectively analyzed.The patients were divided into DM group (n =82) and non-DM group (n =326).The postoperative infection,delayed graft function (DGF),adverse events,and the survival rate of patients/kidneys were comparatively analyzed.Results The incidence of postoperative infection,DGF and adverse events was significantly higher in DM group than in non-DM group (23.2％ vs.15.6％,P =0.04;17.1％ vs.8.6 ％,P =0.04;13.4％ vs.8.3 ％,P =0.03).No significant difference was found in the 1-,2-,and 3-year survival rate of patients and kidneys between the two groups after operation (P＞ 0.05).Conclusion The incidence of postoperative infection,DGF and adverse events is higher in DM patients.The DM does not affect the survival rate of patients/kidneys through appropriate treatment.It is important to prevent complications in DM patients after renal transplantation.

Objective: To investigate the detection rates and inlfuencing factors of atrial septal defect (ASD) and ventricular septal defect (VSD) among neonates in two cities of East China and to provide scientiifc basis for the prevention, diagnosis, treatment and monitor of ASD and VSD. Methods: 2100 newborns with gestational age of at least 28 weeks were recruited consecutively from each city between 2013-09 and 2014-11. Data related to ASD and VSD were collected by questionnaires and echocardiographic screening was conducted within 7 days after birth. Results: A total of 4152 neonateswere examined with gestational age of (39.03 ± 1.29) weeks, among whom 2189 were male infants (52.72%), and age of mother was (26.32 ± 4.10) years old. Detection rates of ASD and VSD were 60.5‰ and 12.8‰ respectively, showing no significant difference between genders (P>0.05). Multivariate logistic regression analysis showed that maternal pre-pregnancy BMI and home decoration were the inlfuencing factors of ASD and maternal drug use in early pregnancy was the inlfuencing factor of VSD among newborns. Conclusions: Detection rates of ASD and VSD among neonates were relatively high in two cities of East China. Early screening is importtant to reduce the incidence of ASD and VSD and improve the prognosis.

BACKGROUND:Reducing the rate of abnormal fertilization is an effective approach to improving the efficacy of in vitro fertilization and reducing patients'financial strain.However,the current research on abnormal fertilization has focused on exploring the types of prokaryotic nuclei and their generation mechanisms,as well as analyzing embryos formed by abnormal fertilization,chromosomal ploidy and utilization value.There is a lack of clinical prediction models for abnormal fertilization based on retrospective studies. OBJECTIVE:To construct a nomogram model to predict abnormal female factors in in vitro fertilization. METHODS:A total of 5 075 patients undergoing treatment for conventional in vitro fertilization at Nanxishan Hospital of Guangxi Zhuang Autonomous Region from March 2017 to March 2022 were retrospectively analyzed.The male confounders were calibrated on a 1:1 propensity score with a match tolerance of 0.02,and 1 672 cases were successfully matched.According to the Vienna Consensus,patients with≥60%normal fertilization capacity were included in the normal fertilization group(n=836)and those with<60%normal fertilization capacity were included in the abnormal fertilization group(n=836).The model and validation groups were obtained by random sampling at a ratio of 7:3.Factors related to the occurrence of abnormal fertilization following conventional in vitro fertilization in the model group were screened using univariate analysis and the best matching factors were selected using the Least Absolute Shrinkage and Selection Operator(LASSO)and included in a multifactorial forward stepwise Logistic regression to identify their independent influencing factors and plot a nomogram.Finally,the prediction model was validated for discrimination,accuracy and clinical application efficacy using receiver operating characteristic curves,calibration curves,clinical decision curves and clinical impact curves. RESULTS AND CONCLUSION:The univariate analysis indicated the factors influencing the occurrence of abnormal fertilization were age,controlled ovarian hyperstimulation protocol,number of assisted pregnancies,years of infertility,infertility factors,anti-mullerian hormone,sinus follicle count,basal luteinizing hormone,luteinizing hormone concentration on the human chorionic gonadotropin day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).LASSO regression further identified the best matching factors,including age,microstimulation protocol,number of assisted pregnancies,years of infertility,anti-mullerian hormone,luteinizing hormone level on human chorionic gonadotropin injection day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).Multifactorial forward stepwise Logistic regression results showed that age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day were independent influencing factors for the occurrence of abnormal fertilization following conventional in vitro fertilization.The receiver operating characteristic curves showed an area under the curve of 0.761(0.746,0.777)for the model group and 0.767(0.733,0.801)for the validation group,indicating that the model has good discrimination.The mean absolute error of the calibration curve was 0.044,and the Hosmer-Lemeshow test indicated that there was no significant difference between the predicted probability of abnormal fertilization and the actual probability of abnormal fertilization(P>0.05),indicating the prediction model has good consistency and accuracy.The clinical decision curves and clinical impact curves showed that the model and validation groups had the maximum net clinical benefit at valve probability values of 0.00-0.52 and 0.00-0.48,respectively,and there was a good clinical application efficacy in this valve probability range.To conclude,the nomogram model has good discrimination and accuracy as well as clinical application efficacy for predicting the occurrence of abnormal fertilization in women undergoing conventional in vitro fertilization based on age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day.