Objective To evaluate the influence of peritoneal transport characteristics on nutritional status of peritoneal dialysis patients and estimate the role of peritoneal transport characteristics and nutritional status in evaluation of peritoneal dialysis adequacy. Methods Peritoneal transport properties (D/Pcr) were evaluated by Short Peritoneal Equilibration Test and then 53 cases were divided into high transport group (D/Pcr ≥0. 65) and low transport group (D/Pcr < 0. 65). Urea kinetics (Kt/v) and total clearance of creatinine (TCcr) were calcu- lated. Serum albumin (ALB), prealbumin, transferring (TF), hemoglobin (Hb), lean body mass (LBM) and LBM% were examined or calculated. Subjective global assessment (SGA) was used to evaluate the nutritional sta- tus of patients. Results There were 30 cases in high transport group and 23 cases in low transport group. D/Pcr (0. 82±0.15 vs. 0. 55±0. 08, P < 0. 01), TCcr (62. 93%±25. 98% vs. 49. 69%±16. 92% , P < 0. 05) and age were significantly higher in high transport group than those in low transport group, while ALB, TF, Hb, LBM% , and SGA were significantly lower than those in low transport group (P < 0.05). ALB was negatively cor-related with Kt/v (r= -0.2708, P<0. 05). Conclusions High peritoneal transport patients have better solute clearance but worse nourishment status compared with low transport ones. Nutritional status is one of the factors to evaluate dialysis adequacy. Nutrition management and guidance should be strengthened for the continuous ambula- tory peritoneal dialysis patients, especially for the elderly ones.

Purpose　To study the clinicopathologic and immunohistochemical characteristics of mantle cell lymphomas(MCL). Methods　Six cases of MCL in lymph nodes were collected and immunohistochemical stains for CD45,CD20,CD79,CD45RO,CD30,CD68,CD43,CD5,cyclinD1,bcl-2,c-myc,IgD and IgM performed. Results　According to the histological pattern, MCL could be divided into 4 subtypes, mantle zone type(1 case), nodular type (1 case), diffuse type (2 cases) and blastoid type (2 cases). The tumor cells were pan-B+, IgD+, CD43+, cyclinD1 + (5/6),CD5+(4/6). Conclusions　MCL is a kind of special immunophenotypic B cell lymphoma. The different histiological subtype may have a different prognosis. The differential diagnosis includes the others B cell lymphomas, for instance, marginal zone B cell lymphomas (MZL),follicular lymphomas(FL), and choronic lymphocytic leukemia/small lymphocytic lymphomas (CLL/SLL).

Objective To investigate the incidence of trisomy 12(+12) and 11 q23 deletion [ del ( 11q23) ] in chronic lymphocyticleukemia (CLL). Methods Fluorescein labeled DNA probe 12 and sequence specific probe ATM for 11q23 were used to perform inter-phase fluorescence in situ hybridization (I-FISH) assays in 30 patients with CLL. The results were compared with that of conventional cyto-genetic (CC) examination. Results With CC examination , only 4 cases (13.3%) were found to have chromosomal abnormalities, whereaswith I-FISH assay ,8 cases (26.7%) were found to have genomic aberrations, including trisomy 12 in 5 cases , deletion of 11q23 in 3 ca-sea. Conclusion I-FISH is a useful method for detection of genomie aberration in CLL, the significance of trisomy 12 and del (11q23) inpredicting the prognosis of B-CLL need to be investigated further.

Objective To develop a questionnaire suitable for China's cultural background on nurses' attitudes towards the causes of aggressive behavior in patients with schizophrenia,and to test its reliability and validity.Methods By literature review,semi-structured interview and combining with the China's conditions,the draft of the questionnaire item pool was formed,which was evaluated by the experts.Then the reliability and validity of the questionnaire were tested by investigating 340 nurses.Results The effective questionnaires were 312 copies.The questionnaire included 4 dimensions and 29 items.Exploratory factor analysis extracted 4 factors,the total explained variance was 56.175％.The Cronbach alpha coefficient of the questionnaire was 0.909,and the dimensions' Cronbach alpha coefficient was 0.812-0.896.The testretest reliability of the questionnaire was 0.897,and the dimensions' test-retest reliability was 0.742-0.886.The average of total questionnaire's content validity index was 0.968 and the average of the dimensions'content validity index was 0.943-0.978.Conclusions The questionnaire has good reliability and validity,which can be used to investigate nurses' attitudes towards the reasons of the aggressive behavior in patients with schizophrenia.

Objective To evaluate the impact of total parenteral nutrition(TPN)on nutrition status and inflammatory markers in hospitalized fasted patients with inflammatory bowel disease(IBD).Methods A retrospective study was performed and 82 hospitalized fasted IBD patients [male/female=58/24,(39.4±14.5)years] who received TPN entered the study.Among them,38 patients had ulcerative colitis(UC)and 44 patients suffered from Crohn`s disease(CD).Clinical data(gender,age,duration of disease,history of disease,prednisone,immuno-suppressor,and antibiotics)were obtained from medical records.Nutritional parameters,C-creative protein(CRP),and erythrocyte sedimentation rate(ESR)before and after TPN were also obtained.Average caloric supplementation by TPN was(4 437.3±1 199.1)kJ/d and the nitrogen amount was(9.9±1.7)g/d.Median PN length was 15 days(7-54 days).67 IBD patients received a TPN formula with glutamine(≥14 d,25 patients vs.0-14 d,42 patients)and 15 IBD subjects received TPN without glutamine.Malnutrition was diagnosed by body mass index(BMI)and serum albumin level.Results The prevalence of undernutrition was 90.2％(74/82)in the study population.CD patients had a significantly longer history of disease [84(3-288)months vs.24(1-324)months,P<0.001] and a significantly lower BMI [(15.6±1.8)kg/m2 vs.(19.1±3.5)kg/m2,P<0.001] compared with those in UC patients.TPN improved nutritional parameters [serum albumin:(28.7±6.6)g/L before TPN vs.(31.7±5.8)g/L after TPN,P<0.001;pre-albumin:(174.1±85.5)mg/L before TPN vs.(227.2±82.8)mg/L after TPN,P<0.001].Conclusions TPN improves nutritional status in hospitalized fasted IBD patients.However,prospective randomized controlled trials are required to estimate the role of low-to-middle dosage of glutamine in IBD patients.

Objective To explore the effect of contract learning on rehabilitation training to patients with stroke . Methods According to the random number table, 120 stroke patients were randomly divided in equal number into control group and observation group. The patients in the control group were treated with conventional nursing during hospitalization and health guidance during follow-up. The patients in the observation group were given rehabilitation training according to contracted learning during the period of hospitalization and follow-up. The time was 6 months. The quality of life was compared between the two groups of patients before and after the intervention, 1 months after discharge, 6 months after discharge. Results After six months of intervention, the 7 dimensions of quality of life, including daily life ability, hand function, mobility, strength, emotion, communication and participation in the intervention group were significantly better than those of the control group (P<0.001). The 6 dimensions of quality of life, including daily life ability, hand function, mobility, strength, emotion, and communication of the control group were significantly better than before the intervention (P<0.001). Conclusion For stroke patients, the rehabilitation training under the learning contract can improve the effect of rehabilitation training so as to improve the quality of life and the prognosis.

Objective:To analyze the splicing mutation site of COL4A5 gene in a family with X-linked dominant Alport syndrome and explore the possibility of exon specific U1 small nuclear RNA (snRNA) gene therapy. Methods:The clinical data of the proband and family members of Alport syndrome were collected, and the gene mutations in the whole exon of a series of nephropathy genes in the proband were detected by high-throughput sequencing. The splice site changes and pathogenicity caused by COL4A5 c.546+5G>A mutation were analyzed by online software. Minigene experiment was used to verify and analyze the effect of COL4A5 gene mutation site c.546+5G>A in the proband of Alport syndrome family, and transient transfection and introduction of modified U1 snRNA to correct splicing mutation. Results:The results of gene sequencing showed that there was a hemizygous variation of COL4A5 gene in the proband and his half brother, and the variation site was c.546+5G>A. The results of online software for analyzing the pathogenicity of splice variation showed that the original donor splicing site could not be detected after mutation, suggesting that there was a great possibility of affecting splicing. The abnormal splicing mode of COL4A5 gene with c.546+5G>A mutation—deletion of exon 9 was verified by hybridized small gene detection. The abnormal splicing mutation could be partially corrected by the modified U1 snRNA. The correction ratios of ExSpeU1 (MT), ExSpeU1(E9+1), ExSpeU1(E9+9) and ExSpeU1(E9+11) to exon 9 deletion caused by c.546+5G>A were 0, 43.81%, 52.09% and 48.12%, respectively. Conclusions:The pathogenicity of the new splicing mutation of COL4A5 is verified, and the modified U1 snRNA can partially correct the abnormal splicing.

Objective:To investigate the familial inheritances, clinical features, treatments and outcomes of familial Waldenstrom macroglobulinemia (WM) patients.Methods:The clinical manifestations, laboratory examinations, diagnosis and treatments, and follow-up data of 6 familial WM patients who were admitted to Yancheng No.1 People's Hospital from June 2002 to July 2019 were retrospectively analyzed, and the literature was reviewed.Results:Among 6 WM patients, 4 patients had dizziness and fatigue at the onset, 1 patient had recurrent low-grade fever and abnormal sweating as the first manifestations, 1 patient was hospitalized due to pulmonary infection, and WM was found later. Two brothers of the patients were diagnosed with WM, another 2 brothers of the patients had IgM-type monoclonal gammopathy of undetermined significance (MGUS) during the physical examination. All the 6 patients were middle-aged/elderly men, with a median age of 63 years old (51-70 years old). The median follow-up time were 71.5 months (4-217 months), and by the end of the follow-up (June 2020), 2 cases died of pulmonary infection, and 1 of them developed acute myeloid leukemia; the other 4 cases were in regular chemotherapy. Two IgM-MGUS patients were followed up without symptoms.Conclusions:WM patients have familial aggregation, and their clinical manifestations are highly heterogeneous. Patients with family history may have poor prognosis. It is necessary to strengthen the awareness of WM and family history screening.