Objective:To evaluate the effect of nursing specialist nurses′ assistance on the ability of nursing home nurses to maintain venous catheter under the vision of combination of medical care and nursing care, providing reference for carrying out specialized nursing assistance work in grassroots hospitals.Methods:This study was an experimental study. According to Miller′s pyramid theory, a model of specialist nurse assistance was established with specialized technology as the core. From January to December 2021, three nursing hospitals in Suzhou were assisted. Convenience sampling method was used to investigate the ability of intravenous catheter maintenance, the incidence of central venous catheter maintenance defects, the incidence of central venous catheter complications and unplanned extubation, and the satisfaction of doctors and patients before and after help.Results:Totally 86 nurses were included, aged (33.17 ± 2.31) years old. After the help, the theoretical and operational skill scores of nurses in the nursing home were (89.77 ± 2.11) and (92.75 ± 1.62) points, respectively, which were significantly higher than those before the help (60.84 ± 2.71) and (79.81 ± 1.68) points, and the differences were statistically significant ( t=-84.96, -52.12, both P<0.05). Among the maintenance defects of central venous catheter in nursing homes, incomplete labeling, film wrapping, blood seepage, catheter discounting, non-standard film fixing, and incomplete information of extended care were 9.95% (21/211), 8.53% (18/211), 2.84% (6/211), 6.16% (13/211), 4.74% (10/211), 2.37% (5/211) after help, all lower than 50.57% (89/176), 43.18% (76/176), 14.20% (25/176), 25.57% (45/176), 18.18% (32/176), 11.93% (21/176) before help. The differences were statistically significant ( χ2 values were 14.00 to 77.81, all P<0.05). The incidence of medical adhesive related skin injury, catheter obstruction complications and unplanned extubation were 4.44% (4/90), 3.33% (3/90) and 2.22% (2/90), respectively, which were lower than 20.51% (16/78), 15.38% (12/78) and 11.54% (9/78) before help. The differences were statistically significant ( χ2=8.81, 6.06, 4.50, all P<0.05). Doctors′ satisfaction with nurses and patients′ satisfaction with nursing work were 96.43%(27/28) and 93.75%(45/48), respectively, both higher than 71.43%(20/28) and 72.73%(32/44) before help, and the differences were statistically significant respectively ( χ2=4.77, 5.97, both P<0.05). Conclusions:From the perspective of combination of medical care and nursing care, the maintenance and assistance of intravenous catheters by the team of intravenous therapy nurses in nursing hospitals can effectively reduce the incidence of central venous catheter complications and unplanned extubation, improve the maintenance ability of intravenous catheters of nurses in nursing hospitals, and help to improve the quality of nursing care in nursing hospitals.

Objective:To summarize the best evidence of exercise management of tumor-associated sarcopenia and provide reference for medical personnel to formulate individualized exercise intervention plans.Methods:BMJ Best Practice, UpToDate, Cochrane Library, Embase, PubMed, CINAHL, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang database, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, and other databases were searched by computer for literature on exercise intervention for patients with tumor-associated sarcopenia, including clinical decision making, guidelines, expert consensus, evidence summary and systematic reviews. The search period was from the establishment of the databases to April 23, 2023. Two researchers independently conducted literature quality evaluation, evidence extraction, and integration.Results:A total of 12 articles were included, including 4 guidelines, 3 expert consensus papers, and 5 systematic reviews. A total of 32 pieces of evidence were summarized from five aspects, including exercise evaluation, exercise timing, exercise plan, exercise management, and evaluation indicators.Conclusions:This study summarizes the best evidence for exercise intervention in patients with tumor-associated sarcopenia and suggestes that medical staff should apply the proof according to the clinical context and the patient's wishes.

Objective:To provide genetic counseling and prenatal diagnosis for a fetus with mosaic trisomy 20.Methods:Chromosomal karyotyping, chromosomal microarray analysis (CMA) and fluorescence in situ hybridization (FISH) were carried out for a pregnant woman with advanced maternal age. Results:The karyotype of amniotic fluid sample was 47, XN, + 20, whilst the result of CMA was normal. To verify this discrepancy, CMA was performed again with the cultured amniotic fluid, which yielded a result of 47, XN, + 20. FISH assay of the amniotic fluid sample was nuc ish(D20Z1)×3[11]/(D20Z1)×2[89], which indicated that about 11% of fetal cells were trisomy 20. After the fetus was born, the karyotype of peripheral blood sample was normal.Conclusion:The amniotic fluid sample might be mosaic trisomy 20, and a dominant growth of 47, XN, + 20 cells had occurred during the culture process, resulting in alteration of amniotic fluid cell composition. Mosaic trisomy 20 indicated by FISH may be attributed to confined placental mosaicism or somatic mosaicism of trisomy 20.

Objective:To investigate the changes of disease constitution in general practice outpatients before and after COVID-19 pandemic.Methods:Rank-sum ratio (RSR)method and Pareto method were used to comprehensively analyze the disease composition of patients in general practice outpatients in Huacao Community Health Service Center of Shanghai from January 2019 to December 2021.Results:The number of visits to general practice clinic decreased from 2019 to 2021. The top five diseases in RSR were circulatory system, endocrine, nutrition and metabolism, respiratory system, digestive system, and nervous system(RSR=1.000,0.917,0.896,0.813 and 0.750), all of which were classified as Class A factors, with a cumulative composition ratio of 80.45%. Taking the above 5 categories as the main diseases, and consistency analysis was performed for the annual changes. The coefficient of concordance of the top five diseases was poor, and not statistically significant ( WR=0.956, χ 2=11.47, P>0.01), suggesting that the disease spectrum was changed. The visits of patients with respiratory diseases dropped from the 2nd place to the 3rd after COVID-19 pandemic, with an average annual change rate of-14.31%, the lowest among all diseases. Among the top five diseases, nervous system disease had the highest annual change rate (7.68%). Among the factors affecting health status and contact with health care institutions, eye and appendage diseases ranked the first with the annual change rate of 12.97% and 10.35%,respectively. Conclusions:After the outbreak of COVID-19 pandemic, the disease spectrum in general practice clinics has changed. Measures must be taken in time to meet the needs for medical care.

Objective: To summarize the clinical features of 7 rare cases of hemolytic disease of newborn (HDN), and to improve the understanding of rare HDN. Methods: Data of clinical information, laboratory findings, treatments and outcomes were collected and analyzed for four cases with HDN due to anti-M, two cases due to anti-Kidd, and one case due to anti-Duffy. All of them were admitted to the Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medial University from July 2007 to June 2017. Results: Among the four MN hemolytic babies, two were males and two were females. Jaundice was found in three cases. Two cases had hyperbilirubinemia, one of them had severe hyperbilirubinemia. All the four cases developed anemia, including severe anemia in three cases. Two cases of Kidd hemolytic disease and 1 case of Duffy hemolytic disease had jaundice and anemia, but did not reach the level of severe hyperbilirubinemia and severe anemia. MN hemolytic disease babies got negative results in direct antiglobulin test, whereas the Kidd and Duffy hemolytic disease babies had positive findings in direct antiglobulin test. None of the babies had blood transfusion, and they were discharged from the hospital. Conclusions Without maternal and fetal blood group incompatibility (ABO or Rh blood-group system), for early onset of jaundice, severe jaundice or anemia, antiglobulin test to mother and child earlier should be administered, and MN, Kidd, Duffy and other rare hemolytic disease of the newborn should be pay attention to.

ObjectiveTo analyze the clinical manifestation of hemolytic disease of the newborn (HDN) due to anti-M and Rhesus system.MethodsClinical information was collected and analyzed for three cases with HDN due to anti-M and 64 with Rhesus hemolytic disease, who were admitted to Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medical University from February 2011 to January 2015, as well as another 28 cases of HDN due to anti-M with complete information retrieved from literature in Wanfang and China National Knowledge lnfrastructure (CNKI) Database from 1992 to 2014.Chi-square test was performed for statistical analysis.ResultsTwo out of the 64 Rh hemolytic babies gave up therapy due to kernicterus and another two out of the 31 MN hemolytic babies, obtained from literature, died 24 h after birth because of anemia or edema, while the rest survived. Although more babies were the first child of the family in HDN due to anti-M than those of Rh hemolytic disease [26%(8/31) vs 9%(6/64),χ2=4.487, P=0.034], but lower incidence of jaundice [81%(25/31) vs 98%(63/64),χ2=9.686,P=0.002], less proportion of presentation of jaundice within 24 h after birth [29% (9/31) vs 64%(41/64),χ2=10.279,P=0.001] and lower positive rate of direct antiglobulin test [39%(12/31) vs 100%(64/64), Fisher exact test,P=0.000] were shown in HDN due to anti-M. No significant difference was found in the incidences of hyperbilirubinemia [58%(18/31) vs 66%(42/64),χ2=0.513], severe hyperbilirubinemia [23%(7/31) vs 36%(23/64),χ2=1.724], anemia [81%(25/31) vs 89%(57/64),χ2=1.253] and severe anemia [29%(9/31) vs 34%(22/64),χ2=0.271] between HDN due to anti-M and Rh hemolytic babies (allP>0.05).ConclusionsHDN due to anti-M and Rhesus hemolytic disease can cause severe pathological jaundice and/or anemia in newborns. Indirect antiglobulin test should be offered when direct antiglobulin test is negative which is helpful in the diagnosis of HDN due to anti-M.

Objective To investigate the access to online health information in community residents.Methods The online health information behaviors in residents of 10 communities in Baiyun District, Guangzhou, China, were in-vestigated with questionnaires and analyzed by SPSS 19 .0 .Results Of the community residents included in this in-vestigation, 25%were positive in access to online health information on general gate website and commercial health information service website, 74.34%showed their concern for food safety information, 52.30%focused their con-cern on disease symptom information, and 66.79%were unable to differentiate true information from false informa-tion.Conclusion The community residents have a low positivity and lack of awareness in access to online health in-formation.It is thus pressingly necessary to build the government-dominated online health information platform, and improve the commercial network model and the ability of community residents to differentiate true information from false information.

Teaching information retrieval course in two phases for students of 8-year clinical medicine was de-scribed in aspects of its contents, organization, teaching material construction and examination methods.Its results were analyzed according to the written examination score, report on a special topic, group report and feedback of students.Measures were put forward for further improving the classroom teaching results, namely effective linking of teaching contents, careful section of retrieval topics, selection and training of teachers.

0.05);the main infection site was lower respiratory tract(61.97%),followed by surgical site infection(SSI)(23.94%).CONCLUSIONS In order to reduce postoperation nosocomial infection rate,we should take following measures:Improve pulmonary function,remove tracheal intubation as early as possible,shorten lasting time of surgery and days before operation,keep aseptic technique,strengthen nursing,enhance immunity,and use antimicrobial agents reasonably.

Objective To analyze the expression of dystrophin associated glycoprotein complex (DGC) in Duchnne muscular dystrophy (DMD) in different age groups. Methods The confirmed 24 DMD patients were divided into 3 groups according to their chronological age (children whose age between 1 to 3 were assigned to early childhood group; children whose age between 3 to 6 were assigned to preschool group; children whose age between 6 to 13 were assigned to school-age group). Several proteins from sarcolemmal muscle membrane were analyzed by immunohistocbemistry. Results The primary loss of dystrophin may lead to a secondary or completely deficiency of α-SG, β-SG, γ-SG,δ-SG, β-DG and dysferlin from sarcolemmal muscle membrane in different age groups. The expression of nNOS is completely deficient in the 3 groups, while the expression of caveolin-3 increased. Conclusions The expression of dystrophin related DGC proteins from DMD patients in different age groups showed diversed degrees of deficiency or complete deficiency. The deficiency of these proteins may occur during the embryonic period, while the increased expression of eaveolin-3 may have a relation with the regeneration of skeletal muscle fibers.