Objective To systematically the effect of mindfulness-based stress reduction(MBSR) on improving perceived stress and sleep disturbance in cancer patients.Methods The databases of PubMed(Medline),Cochrane,BIOSIS Previews,Web of Science,CBM,CNKI,VIP and Wanfang Data were retrieved by computer,moreover the related journals and included reference literatures were retrieved by manual searching for finding the randomized controlled trials(RCTs) on the application of MBSR in perceived stress and sleep disturbance of cancer patients.Two reviewers independently screened the literatures according to the inclusion and exclusion criteria,extracted the data,and assessed the quality of RCTs.The meta analysis was conducted by adopting the RevMan 5.3 software.Results Nine RCTs involving 974 patients were included.The meta analysis results indicated that the improvement of perceived stress and sleep disturbance after intervention had statistical difference between the MBSR group and control group[MD=-4.63,95％CI(-5.10,-4.17),P＜0.01,MD=-2.18,95％CI (-2.35,-2.01),P＜0.01],but the difference after 3-month intervention between the two groups was not statistically significant.Conclusion The present evidences show that the MBSR method can relieve the perceived stress and sleep disturbance in cancer patients during a short period,but long term effect still needs to carry out more researches to be verified.

Objective In order to evaluate the nutritional effect of early enteral nutrition in patients of Chinese domestic gastric cancer surgery,using evidence-based medicine methods,and supply evidence for clinical nutrition intervention.Methods CBM,Chinese academic Journals,Wanfang database and VIP Information Resource System were searched from January 2000 to March 2013 to collect the published clinical randomized controlled trials literatures of nutrition support in patients of Chinese domestic gastric cancer surgery according to inclusion and exclusion criteria of literature,using the Cochrane System Evaluation Handbook independent,double-blind principle of the literature methodology quality evaluation.Finally Meta analysis was conducted by using RevMan5.2 software.Results 14 articles were enrolled in the study,Meta analysis results showed that:early enteral nutrition comparing with parenteral nutrition in postoperative gastric cancer patients:the WMD of serum albumin was 1.55,95％ CI (0.81,2.29); the WMD of serum transferrin was 0.34,95％CI (0.30,0.38);the WMD of postoperative anal exhaust time was-20.66,95％CI (-23.91,-17.40).Conclusions Early enteral nutrition is better than the parenteral nutrition,which can restore adequate serum protein source for patients,and can recover the gastrointestinal digestion and absorption function of itself earlier,which is worthy of clinical promotion.

Objective To investigate the effect of ultrasound combined with intravenous terbutaline sulfate for external cephalic version and the impact of this therapy on maternal and neonatal complications.Methods 126 singleton pregnant women who were diagnosed by B-ultrasound breech pregnancy at 34-36 weeks in regular antenatal examination from January 2014 to June 2016 were randomly divided into an observation group (n =70)and a control group (n =50).The observation group was treated with intravenous drip of terbutaline sulfate after epidural anesthesia,and then received external cephalic version under B-ultrasound monitoring.The control group received traditional knee-chest position for correcting breech presentation.The success rate of breech correction,breech version rate,cesarean section rate,vaginal delivery rate,adverse reactions,postpartum hemorrhage volume,neonatal asphyxia,and neonatal birth injury were noted and compared between the two groups.Results As compared with the control group,the observation group had a higher success rate of breech correction and a higher rate of vaginal delivery while a lower rate of cesarean section,with a significant difference (x2 =20.210,8.564;P ＜0.05).The rate of postpartum hemorrhage,neonatal asphyxia,or neonatal birth injury did not differ significantly between the two groups (P ＞ 0.05).Conclusions Application of ultrasound combined with intravenous terbutaline sulfate in external cephalic version is easy to operate and has a higher success rate and greater safety,significantly reducing the rate of cesarean section and improve the success rate of vaginal delivery.

An electrospray/ultraviolet lamp dual-source ion trap mass spectrometer was developed for the rapid detection of gas and liquid samples.The instrument used the discontinuous atmospheric pressure sampling technique that both the electrospray ions and gaseous analytes were sampled and transferred using a pinch valve device.The two ionization sources were generally suitable for different kinds of analytes and provided complementary applications.Electrospray was used for the ionization of polar compounds in solution, while the UV ionization source was mainly applied for the analysis of gaseous organic compounds.A variety of samples such as anisole, toluene, 2,4-dimethylaniline, arginine, reserpine and aspartame were employed to test the performance in different working mode of the instrument.The results showed that the two sources were feasible for ionization of different types of samples, and different types of molecular ions could be generated when 2,4-dimethylaniline was analyzed.The two ionization sources could be used alternately or simultaneously without interference, and the working mode was also switched to fit the application requirements.The dual-source configuration was an effective way to extend the applications for miniature mass spectrometers.It did not significantly increase the size of the instrument, but provided more versatile analysis to meet the need for the measurement of different types of samples.

Objective To explore the relationship of empathy ability and leadership among nurse managers.Methods 184 nurse managers completed the Interpersonal Reactivity Index-Chinese Version (IRI-C)scale and Leadership Questionnaire for Nursing Manager for empathy and leadership.Results The average score of the empathy is 57.72±8.59,the average score of leadership is 102.38±14.38.The relationship between empathy and leadership is positive and the coefficient of correlation is r =0.21,(P＜0.05).Conclusion The empathy and leadership ability of the nurse managers surveyed are found to be at intermediate level; empathy ability and leadership have positive interactions; and improved empathy ability of nurse managers can strengthen their leadership.

We investigated the carrying situation of Escherichia albertii from healthy people engaged in breeding and slaughtering poultry for a long time.We collected stool samples from people engaged in breeding and slaughtering poultry and other healthy people.After enriched with EC broth,eae-positive enrichment culture was directly streaked on MacConkey,and eaepositive lactose non-fermenting isolate was retained for further investigation.The 16S rDNA sequencing and multilocus sequence typing (MLST) were applied in the identification of E.albertii from suspected strains.Intimin subtypes and cdtB types of E.albertii strains were detected.Pulsed-field gel electrophoresis (PFGE) was used to detected genetic polymorphism of strains from this study and animal source ones.Results showed that two isolates were identified as E.albertii from 189 stools of people exposed to slaughtering chickens and ducks and one from 58 stools in control groups.No isolate was identified as E.albertii from 138 stools samples of people exposed to breeding poultry.Intimin subtypes of three isolates from stool samples were subtyped as sigma,iota 2,nu,and cdtB types were closely related to types Ⅱ/Ⅲ/Ⅴ.PFGE patterns of the three strains was distinguishable (＜80％ similarity),and appeared in different cluster with chickens,ducks and other sources of E.albertii strains.The rate of carrying E.albertii to a certain extent exist in healthy people engaged in slaughtering chickens and ducks,and the relationship between these strains and strains from poultry should be further investigated.

Objective:To explore hot spots and trend of medical education quality assurance research in China and provide reference for future research.Methods:We searched the database of CNKI, VIP, Wanfang Database for published studies on quality assurance of medical education research in China. In the form of knowledge mapping, word frequency analysis, social network analysis and cluster analysis were used to explore the research hot spots from the perspective of high frequency keywords. SATI3.2 and Excel tables were used as statistical analysis tools for bibliographic information, the field extraction and word frequency statistics of literature keywords. Using SPSS 20.0, cluster analysis was carried out according to the similarity matrix of high frequency keywords co-occurrence.Results:Totally 249 articles were included in the study and 33 high frequency words were taken into account. The research hot spots of medical education quality assurance in China were divided into four categories: the practical application of medical education quality assurance, the effective methods of medical education quality assurance, the exploration of the construction of medical education quality assurance system, and the management of medical teaching quality assurance.Conclsion:Medical education in our country should perfect the safeguard measures to form characteristic theory framework, explore other methods for medical education quality assurance, establish medical education education quality guarantee system, and strengthen the teaching quality monitoring. The future researches should comply with the national "Double First-rate" construction and the development trend of international medical education, and enhance the research of connotative quality assurance.

Objective To assess the diet quality of pregnant women during the second trimester using the dietary inflammatory index ( DII) and to explore the correlation between the DII in second trimester of preg-nancy and preterm delivery.Methods A total of 253 women with singleton pregnancy in 16-20 gestational weeks who had received routine prenatal care between August 2014 and April 2015 at the First Affiliated Hospi-tal of Anhui Medical University were enrolled with cluster random sampling.The included women were asked to recall daily dietary intake in the 3 days prior to the survey.All dietary data were analyzed for energy and nutri-ents intake with a nutritional analysis software, followed by calculation of DII according to previous reports. Based on quartiles of the DII scores, the participants were divided into three groups, namely the anti-inflam-matory group (DII<-5.10), intermediate group (DII -5.10--2.55), and the pro-inflammatory group (DII>-2.55).The participants were followed up until delivery and the pregnancy outcomes were recorded. The relationship between the DII in second trimester of pregnancy and preterm delivery were analyzed. Results DII scores of the 253 pregnant women during the second trimester of pregnancy ranged from -7.913 to 3.872.The risks of preterm birth in the anti-inflammatory diet group, the intermediate group, and the pro-inflammatory diet group were 0, 1.6%, and 6.3%, respectively, with statistically significant differences among the groups (P=0.034).The higher DII scores (pro-inflammatory) were associated with higher inci-dence of preterm birth ( P<0.05 ) .Conclusion DII may be used to assess diet quality of pregnant women during the second trimester and to predict the risk of preterm birth.

BACKGROUND:Despite unrelated cord blood transplantation is expected to become an important method for treating malignant hematological diseases,the manifestation and clinical characteristics of acute graft-versus-host disease in the gastrointestinal tract still require further in-depth investigation. OBJECTIVE:To analyze the clinical characteristics of intestinal acute graft-versus-host disease after unrelated cord blood transplantation. METHODS:A retrospective analysis was conducted on 668 malignant hematological disease patients after unrelated cord blood transplantation who underwent hematopoietic stem cell transplantation subspecialty in the Department of Hematology,First Affiliated Hospital of University of Science and Technology of China from December 2016 to December 2020.Among them,clinical data of 138 patients with intestinal acute graft-versus-host disease were analyzed,including 76 males and 62 females,with a median age of 13(1-62)years.All patients were treated with a myeloablative regimen(without antihuman thymocyte globulin)and cyclosporin A combined with mycophenolate mofetil to prevent graft-versus-host disease. RESULTS AND CONCLUSION:(1)The patients with intestinal acute graft-versus-host disease had diarrhea of varying degrees,most of which were yellow-green,yellow-brown watery stools or mucous stools.53 patients(38.4%)had blood stools,82 patients(57.9%)had skin involvement,18 patients(13.0%)had a secondary intestinal bacterial infection,and 90 patients(65.2%)had cytomegaloviremia.(2)The clinical characteristics of patients(70 cases,50.7%)with grade 1-2 intestinal acute graft-versus-host disease were compared with those(68 cases,49.3%)with grade 3-4 intestinal acute graft-versus-host disease.It was found that the age of grade 3-4 intestinal acute graft-versus-host disease patients was higher than that of grade 1-2 intestinal acute graft-versus-host disease patients(P<0.001),and they were complicated with cytomegaloviremia probably(P=0.035).Diarrhea lasted longer(P=0.00)and the length of hospital stay increased substantially(P<0.001).However,there were no significant differences in recipient gender,pre-transplant disease status,HLA matching,diagnosis,combined skin graft-versus-host disease,and secondary intestinal infection rate in patients of the two groups.(3)These findings conclude that the clinical characteristics of intestinal acute graft-versus-host disease after unrelated cord blood transplantation are complex,which affects the prognosis and quality of life of patients seriously and requires early identification and precise treatment.

Objective: To investigate the incidence and risk factors of extraintestinal manifestations (EIMs) in children with inflammatory bowel disease (IBD). Methods: The clinical data of 161 children with IBD was collected from the electronic medical records in the Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine from January 2012 to December 2017. These patients were divided into Crohn′s disease (CD) group and ulcerative colitis (UC) group, accounting for 82.0% (132 cases) and 18.0%(29 cases), respectively. The incidence of EIMs in each group was analyzed. The potential risk factors of EIMs including the IBD phenotype, gender, age, location of the CD lesion, disease activity of CD, and the presence of perianal lesion were analyzed with logistic regression model. Results: Eighty-eight patients (54.7%) had EIMs. The main EIMs were immune-mediated EIMs and growth retardation, accounting for 41.0% (66/161) and 24.2% (39/161), respectively. Aphthous ulcer (39/161, 23.0%) was the most common symptom among immune-mediated EIMs, followed by arthropathy (20/161, 12.4%) and skin lesions (19/161, 11.8%). Forty-three patients (26.7%) had EIMs before being diagnosed as IBD. Fifty-eight (65.9%) patients had only one EIM during the whole course of IBD. By logistic regression analysis, CD (OR=5.536, 95%CI:1.825-16.788) and perianal disease (OR=1.969, 95%CI:1.035-3.746) were the risk factors of immune-mediated EIMs. Meanwhile, CD (OR=11.319, 95%CI: 1.487-86.179), younger than six-year-old at diagnosis (OR=8.556, 95%CI: 3.109-23.545), moderate to severe activity of CD (OR=3.447, 95%CI: 1.196-9.934) and perianal disease (OR=3.361, 95%CI: 1.720-7.793) increased the risk of growth retardation. Conclusions The children with IBD have a high incidence of EIMs, which were more common in CD than in UC. The risk factors of developing EIMs include CD, perianal diseases, younger than six-year-old at diagnosis and moderate to severe activity of CD.