Objective To study the Inflammation and immune stress of obese asthmatic rats by adipocytokines.Methods Fourty C57BL/6 J mice were randomly divided into control group, obese group, asthma group and obese asthma group.Mice in the control group were fed normal diet and PBS, high-fat diet(75% normal diet, 10% egg yolk powder, lard 10%, 5% sugar)and PBS in obese group, normal diet and OVA(PBS)in asthma group and fat diet and OVA(PBS)in obese asthma group.Detect the leptin, adiponectin, resistin, IL-4, IFN-γ, IL-17 content with ELISA in serum and bronchoalveolar lavage fluid(BALF).Using Pearson correlation to analyze and evaluate these factors' correlation in plasma and BALF.Results The difference of leptin, adiponectin, resistin in plasma and BALF(excepted leptin)between four groups were statistically significant (P<0.05), the leptin levels between plasma and BALF has a positive correlation(R2=0.8215, P<0.05)in obese mice, there was no correlation between plasma and BALF for the adiponectin, resistin.The adiponectin content and IFN-γ levels were also negatively correlated(R2=0.9146, P<0.05)in BALF, while there was no correlation between IL-4,IL-17 and leptin, adiponectin, resistin.Conclusion Adipocytokines has a regulatory function of the immune response in obese asthmatic rats, and participate the inflammatory reaction.

Objective To study the effect and safety of modified Valdivia position and prone position in percutaneous nephrolithotomy(PCNL) on renal calculi.Methods The clinical data of 94 patients with solitary renal calculi admitted in our hospital from September 2015 to November 2016 were enrolled to this study,who were divided into control group and study group by surgery methods and body position,47 cases in each group.The control group received PCNL with prone position,and the study group were treated by PCNL with modified Valdivia position.The operative condition,postoperative condition,stone clearance rate and incidence of adverse reactions between the two groups between two groups were compared,and the levels of diastolic blood pressure(DBP),systolic blood pressure(SBP) and heart rate(HR) between the two groups were observed.Results After position placement,DBP and SBP level decreased in both groups,the level of DBP and SBP in study group were lower than the control group,the difference was significant(P<0.01).There was no significant difference in the level of HR between two groups(P>0.05).The operative time,intraoperative blood loss,hospitalization time,reoperation rate and blood transfusion rate in the study group were lower than those in control group,the differences were significant(P<0.05),the removal rate of stones was significantly higher than that of control group(χ2=9.55,P=0.00).The rate of chest stuffy and dysphoria in the study group were higher than those in control group(P<0.05).The incidence of infection,hemorrhage,pleural injury and renal injury were slightly lower than those of the control group,but there was no significant difference between two groups(P>0.05).Conclusion PCNL with modified Valdivia position has high safety and significant effect on patients with kidney stones,which can effectively remove stones,reduce operation time.

Objective To explore the application value of VCT 64-row with 128-layer spiral extremities arterial imaging techniques and methods in the double lower limb artery.Methods 60 patients on lower limbs MSCTA angiography after Saul,flat on intravenous regiment note contrast agents CT angiography,image the maximum intensity projection(MIP),curved planner reconstruction(CPR),volume rendering(VR)after-treatment technology reconstructed vessels.Results All 60 patients showed the lower limb arterial and main branch.Conclusion 64-row helical VCT angiographic with 128-layer could clearly show that lower limb artery and pathological changes,and become main methods of preoperative evaluation and selection for the lower limb artery disease.

Objective To identify the success rate of peripheral indwelling needle puncture in pediatric patients, and analyze its influencing factors. Methods A survey was conducted in a sample of 902 pediatric patients.Personal information table of pediatric patients who receive infusionwas adopted to collect data. Results The success rate of first puncture was 85.37%(770/902), the success rate of two punctures was 95.34%(860/902). The success rate was affected by several factors, such as department, ages of the patients, condition of the veins, years of working as a nurse(OR=1.128, 2.308, 2.351, P <0.05). Conclusions Success rate of peripheral indwelling needle puncture in children still can be improved. When formulate management program, the influencing factors should be considered for management standard.

Objective:To investigate the status and feasibility of evidence-based nursing practice of pain assessment in pediatric nurses and to analyze its influencing factors.Methods:The convenient sampling method was adopted to select pediatric nurses who met the inclusion and exclusion criteria in Children's Hospital of Shanghai Jiao Tong University from August to December 2018 as the research objects. The Questionnaire on Status of Evidence-Based Nursing Practice of Pain Assessment in Nurses was used to investigate and the influencing factors were analyzed. A total of 300 questionnaires were issued and 265 valid questionnaires were collected, with an effective recovery rate of 88.33%.Results:The evidence-based nursing practice score of pain assessment of 265 pediatric nurses was (114.22±19.81) . The highest score was the dimension of pain screening, and the lowest score was the dimension of communication with patients and their families in pain assessment. Univariate analysis showed that there were statistically significant differences in the total scores of pain assessment evidence-based nursing practice among pediatric nurses in their departments and their doctors' support for pain treatment, whether pain was listed as the fifth vital sign, and whether pain care system was established ( P<0.05) . Multiple linear regression analysis showed that doctors' support for pain treatment, whether the department listed pain as the fifth vital sign and whether the pain care system was established were the influencing factors for pain assessment evidence-based nursing practice of pediatric nurses ( P<0.05) . Conclusions:At present, pediatric nurses in Children's Hospital of Shanghai Jiao Tong University, have a relatively high level of evidence-based nursing practice in pain assessment. However, it is necessary to strengthen communication with patients and their families, establish relevant systems within the department, enhance medical cooperation and promote knowledge transformation of evidence-based nursing for pediatric pain assessment.

Objective:To translate the 16-item version of Quality of Life in Children with Epilepsy (QOLCE-16) into Chinese, and conduct reliability and validity analysis in Chinese children with epilepsy.Methods:The International Functional Assessment of Chronic Illness Therapy (FACIT) translation method was adopted. Three bilingual translators pre-translated the source scale, and another three bilingual translators performed back translation. The QOLCE-16 was adjusted through the cognitive interview and expert consultation. This study was a cross-sectional study. Convenience sampling was used to select 256 children with epilepsy who were admitted to the Department of Neurology of Children's Hospital of Shanghai from June to December 2020. All questionnaires were filled out by long-term caregivers, and 256 copies were finally recovered effectively to analyze the reliability and validity of the QOLCE-16 after cultural adjustment in the evaluation of the health-related quality of life of children with epilepsy. A total of 40 subjects were selected from the sample, and the Chinese version of QOLCE-16 was filled out again at an interval of 2 to 3 weeks. Finally, 32 samples were effectively recovered to evaluate the test-retest reliability of the scale.Results:The Chinese version of QOLCE-16 had 16 items in total, including 4 dimensions of cognition, emotion, social interaction, and physical function. Each item had a good degree of discrimination, and there was a statistical correlation with the total score of the scale ( P<0.05) . The scale-level content validity index ( S- CVI) was 1.00, and the item-level content validity index ( I- CVI) was from 0.89 to 1.00. The KMO value of exploratory factor analysis was 0.909, the eigenvalues of each dimension were 3.482, 3.223, 3.136, 2.955 respectively, and the cumulative variance contribution rate was 79.976%. The Cronbach's α coefficient of the scale was 0.938, and the Cronbach's α coefficient of each dimension was from 0.866 to 0.939. The split-half reliability was 0.814, and the split-half reliability of each dimension ranged from 0.840 to 0.942. The test-retest reliability of the scale was 0.724, and the test-retest reliability of each dimension was from 0.615 to 0.716. Conclusions:The Chinese version of QOLCE-16 has good reliability and validity, and can be used as a simple tool for evaluating the health-related quality of life of children with epilepsy between 4 and 18 years of age.

Objective? To investigate the current situation of the self-efficacy in the main caregivers of pediatric enterostoma patients and its influencing factors, to provide scientific basis for formulating continuing nursing intervention measures for children with enterostomy. Methods? A cross-sectional investigation was carried out. The primary caregivers of the pediatric enterostoma patients who were treated in a ClassⅢ Grade A children's specialized hospital in Shanghai during January 2016 to October 2017 were selected by convenience sampling method. A self-designed general information questionnaire, General Self-Efficacy Scale (GSES), and Hamilton Depression Rating Scale (HAMA) were applied in the investigation. Univariate analysis and multiple linear regression analysis were applied to analyze the influencing factors of self-efficacy. A total of 92 questionnaires were sent out, and 90 were recovered, with a valid rate of 97.83%. Results? The median score of GSES among the 90 primary caregivers of the pediatric enterostoma patients was 24, ranging from 13 to 36, which was at a median to low level. The result of univariate analysis showed that there were significant differences in the distribution of caregivers' self-efficacy scores in terms of education level, residence, family monthly income, health insurance, family structure type and doctor-patient communication level (P＜ 0.01). Multivariate linear regression analysis showed that caregivers' educational level, family type, anxiety level and family monthly income were the main factors affecting their self-efficacy. Conclusions? The self-efficacy level of the main caregivers of children with enterostoma needs to be improved. We should strengthen doctor-patient communication for caregivers with lower education, encourage seeking social support, expand information acquisition, enhance care ability and improve the quality of life of children.

Objective To summarize the management experience of Children's Hospital of Shanghai in extracorporeal membrane oxygenation (ECMO) bedside first-aid coordination, and to further strengthen the operation room's emergency management capacity for first-aid of children.Methods Our hospital formed a technical group for ECMO surgical nursing, cultivated nurses' capacity in ECMO first-aid coordination, standardized surgical safety management in multiple departments and areas, and improved relevant management systems to ensure easy access to ECMO first-aid.Results In 2016, our hospital conducted totally 11 ECMO bedside treatment, and there was no wound infection after the treatment, with a weaning success rate of >90% and a hospitalization survival rate of >70%.Conclusions Emergency management strategies play a positive part in improving surgical safety and the operation room's emergency service capability.