Objective:To investigate the complication and compliance of different supine time and the degree of obedience in children with leukemia after intrathecal chemotherapy.Methods:A total of 553 children with leukemia after intrathecal chemotherapy from April 1, 2017 to March 28, 2019 in Beijing Children′s Hospital Affiliated to Capital Medical University were selected. Children who received intrathecal injection from April 1, 2017 to December 31, 2017 were selected as control group(274 cases), from January 1, 2018 to March 28, 2019 were selected as research group(279 cases). The children in research group were supine 2 hours but control group were supine 4 hours after intrathecal. The complications that occurred after injection and within one week after injection and compliance were observed.Results:Finally, 457 children included in this study, there were 235 cases in research group and 222 cases in control group. The number of cases of limb numbness and local pressure reddening in the research group and the control group were 18, 20 and 31, 34, respectively, with statistically significant differences between the two groups( χ2 values were 4.74, 5.07, P<0.05). After intrathecal injection, the patients' compliance with the time of supine removal was completely acceptable to the research group, relatively acceptable, acceptable, and required efforts to adhere to the number of cases were 65, 83, 42, 45, respectively, while the control group were 34, 50, 76, 62, respectively, the differences were significant ( χ2 value was 30.04, P<0.05). Conclusions:Supine for 2 hours after intrathecal injection can reduce the incidence of complications and improve compliance, which is safe and feasible. So, supine for 2 hours after intrathecal injection is recommended.

This paper summarized nursing experience of 11 patients with refractory or relapsed neuroblastoma who developed CAR-T adverse reaction after receiving the transfusion.Nursing key points included:close monitoring of changes of vital signs,especially body temperature and blood pressure;observation of changes of skin,avoiding scratching when skin rash occurred,and daub calamine lotion was applied;strict recording input and output volume of 24 hours,ensuring patency of venous catheters and constant infusion of liquid,observing changes of urine volume and color;strengthening prevention of infection,strict operation of antiseptic technique,protective isolation when moving in laminar flow clean room;monitoring changes of face,breathing,blood oxygen and so on.Through careful treatment and nursing care,the treatment of children was ensured.

Objective To compare the cost-effectiveness and cost-utility of venlafaxine and mirtazapine in patients with treatment-resistant major depression (TRD).Methods One hundred and five patients with TRD were enrolled in this study and grouped into venlafaxine treatment (n=50) and mirtazapine treatment (n=55) based on the double-blind randomization scheme generated by computer.The treatment costs of antidepressants during 8 weeks were calculated,the rates of clinical response and remission were taken as treatment effectiveness,and the quality-adjusted life years (QALYs) as treatment utility.The descriptive analysis and nonparametric test were used to compare the cost-effectiveness and cost-utility of different groups.Results During 8 weeks,the treatment cost of antidepressant was ￥ 1 396.44 for venlafaxine and ￥ 1 206.90 mirtazapine,and the difference between two groups was ￥ 189.54.The cost-effectiveness ratios between venlafaxine and mirtazapine were very close (differed ￥ 0.06 for remission rate and ￥ 1.08 for response rate respectively).There was no significant difference for cost-utility ratios between two groups (physical functioning Z=-0.15,P＞0.05 ; mental health Z=-0.54,P＞0.05).Conclusion Both cost-effectiveness and cost-utility of venlafaxine in patients with TRD are close between venlafaxine and mirtazapine.

Objective To investigate the relations between microRNA-451 (miR-451) expression and gastric cancer (GC).Methods Expression of miR-451 in tumor and paired non-cancerous tissues was measured by real-time quantitative polymerase chain reaction.The association of miR-451 expression with clinical pathological characteristics and prognosis was statistically analyzed;in addition,slow virus LV-mir-451 was applied to infect human gastric cancer cell line BGC-823 and MKN-45,and construct miR-451 over-expressed stable cell lines.Finally,to detect cell proliferation,migration and invasion.Results miR-451 expression decreased in GC tissues vs.pericarcinous tissues (0.010 ± 0.007 vs.0.014 ± 0.008,t =3.015,P ＜ 0.05),and its down-regulation positively correlated with lymphatic metastasis,clinical staging and shorter overall survival.miR-451 expression in BGC-823 and MKN-45 cells did not impact on cell proliferation,but did reduce migration rates (0.863 ±0.026 vs.1.107 ±0.032,t =9.820,P＜0.05;0.863 ±0.026 vs.1.060±0.054,t =4.369,P＜0.05) and invasion rates (1.040 ± 0.055 vs.1.522 ± 0.001,t =5.84,P ＜ 0.05;1.040 ± 0.055 vs.1.696 ± 0.078,t =10.16,P ＜ 0.05) in BGC-823 cells.Conclusions miR-451 may act as a prognostic marker in GC.

Objective:Previous studies suggested that the-308G/A allele in the tumor necrosis factor-α(TNF-α) gene promoter (-308G/A) may be a potential risk factor for inflammatory diseases and tumor progression. However, only a few studies have focused on the-308 polymorphism of TNF-αgene with primary lung cancer in Chinese population. This study aims to evaluate the role of TNF-α-308G/A single nucleotide polymorphism (SNP) and the risk of primary lung cancer in Chinese population. Methods:A total of 250 patients and 447 healthy individuals (control group) were involved in this study. Genotyping was performed using TaqMan technology. Results:The frequencies of (GG), (A/G), and (A/G+AA) genotypes of-308G/A SNP in TNF-αgene were 183 (73.2%), 67 (26.8%), and 67 (26.8%) in the patients, and 406 (90.8%), 39 (8.7%), and 41 (9.2%) in the control group, respectively. The distribution of poly-morphism frequencies in the case group and the control group showed a statistically significant difference for the Chinese population (P<0.05). Conclusion:Results indicated that TNF-αgene polymorphism at position-308G/A is associated with susceptibility to lung cancer in Chinese Han population.

Objective To explore the trend of changes of Th1 and Th2 cytokines within 6 months after adult liver transplantation (LT). Methods Twenty-three patients from Tianjin First Center Hospital were chosen as the patient group with an average age of (52.7 ± 7.6), range from 37 to 63 years old, including 21 males and 2 females. Twenty healthy staffs from Tianjin First Center Hospital formed the control group (C) with 15 males and 2 females whose average age was (31.0 ± 6.1) ranged from 22 to 24 years old. The patient group was treated with tacrolimus after LT as main immunosuppressive drug. The peripheral blood at time points before (T0) and 1 month (T1), 3 months (T3), 6 months (T6) after LT at 9:00 AM were collected. The blood sample was also collected form control group but only one time. Levels of IL-2, IFN-γ, IL-10 and TGF-βwere detected by ELISA. Results (1) The concentration of IL-2 showed a continuous up-going trend, which was not such obvious between T1 and T0, and until T3 reached a higher concentration than T0. The concentration at T6 was higher than T0 and T1. There were no significant differences in concentrations of T0 to T3 between patient group and control group, while T6 reached a higher concentration in patient group than that of the control group. (2) The concentration of IFN-γexperienced a shortly down-going trend from T0 to T3, and started rising, reached the peak at 3 months after the operation, then started its down-going trend. There were no significant differences in the concentrations of IFN-γfrom T1 to T6, and T3 reached a higher concentration than T1 while T6 was lower than T3. Only at T3, the concentration of IFN-γwas higher in patient group than that of control group. (3) There were no significant differences in the concentrations of IL-10 at various time points in patient group, and there were no significant differences in the concentrations of IL-10 at different time points between two groups (P>0.05). (4) The concentration of TGF-βshowed a gradual decline after the operation, and reached its bottom at T6, and which was lower than T0 to T3. Compared with the control group, the down-going trend was not such obviously at T0 and T1, and the concentration was down at T3 and T6(P<0.05). Conclusion Our results suggest that there is a tendency of an increasing Th1 cytokine expression at early stage in post-transplantation, while the TGF-βof Th2 cytokine is a decreasing trend. This tendency may associate with the autoimmunity response caused by LT and the immunosuppressive drugs.

Objective:To analyze the public demands for information about congenital birth defects in “Baidu zhidao” based on word frequency retrieval.Methods:Based on discussion between obstetrics and gynecology experts and epidemiological experts, the key words related to congenital birth defects were determined and the search strategy was formulated. Python 2.7 was used for web crawler search. Questions related to congenital birth defects were obtained on the “Baidu zhidao” platform, and then the R 4.0.2 software was used to process the data, complete the semantic analysis of keywords and statistical analysis of word frequency, and draw word cloud graph and polar chart to describe the key results.Results:A total of 16668 non-repetitive questions were retrieved from “Baidu zhidao” platform, and the frequency of semantic words was 15 371. Among them, 35.02% were the names and symptoms of congenital birth defects. In addition, the frequency of congenital heart disease was the highest (26.09%). The results of subject analysis of key words of birth defects showed that the average word frequency of diagnosis and treatment semantic words (49.55) was significantly higher than that of etiology and prevention semantic words (12.47). In addition, the key words of examination, cause, treatment, development and heredity were more frequently used in the semantic words related to the seven types of systemic malformations.Conclusion:The public in China has a high demand for information on congenital birth defect related diseases, and their causes, prevention and treatment, especially congenital heart disease.

Objective:To retrieve and summarize the best evidence of peripherally inserted central catheters (PICC) related bloodstream infection prevention and to evaluate the evidence, so as to provide reference for clinical implementation of preventive measures for catheter-related bloodstream infection.Methods:National Institute for Health and Care Excellence (NICE) , National Guideline Clearinghouse (NGC) , Guidelines International Network (GIN) , Scottish Intercollegiate Guidelines Network (SIGN) , Australian Joanna Briggs Institute (JBI) Evidence-based Health Centre Database, UpToDate, BMJ Best Practice, Cochrane Library, China National Knowledge Infrastructure (CNKI) , Wanfang and related professional websites such as Infusion Nursing Society (INS) , Medlive and official website of the National Health Commission were searched for all clinical decisions, guidelines, expert consensus, evidence summary and systematic reviews related to the prevention of PICC catheter-related bloodstream infections. The retrieval time limit was from the establishment of the databases to May 2021. Four researchers evaluated the quality of the literature, and two researchers extracted and summarized the evidence.Results:A total of 9 articles were included, including 1 clinical decision, 1 standard of practice, 4 guidelines and 3 evidence summaries. Finally, 29 pieces of evidence were included from 5 dimensions, including organization management, infusion tool selection, catheterization maintenance and use, health education and extubation.Conclusions:The summary of the best evidence for the prevention of PICC related bloodstream infection covers a wide range of areas. Managers and clinical medical staff should apply the evidence according to the specific medical situation to reduce the occurrence of clinical PICC catheter-related bloodstream infection.

Objective To explore the occurrence of pain in the treatment of children with malignant tumors and their perception and cognition of pain, and provide a reference for strengthening pain management and formulating clinical nursing measures. Methods Totally 179 children with malignant tumors admitted in the daytime wards of a Class Ⅲ Grade A children's hospital in Beijing from June 2017 to October 2018 were selected and investigated with the self-made pain questionnaire for children with malignant tumors. Totally 179 questionnaires were distributed and collected in this study, accounting for an effective recovery rate of 100％. Results The incidence of pain in the 179 children was 98.3％ (176/179). The severest pain score was (5.41±2.09), and the average pain score was (3.95±1.66). Pain involved the abdomen, lower limbs, oral mucosa, bones and joints, waist, back, upper limbs, chest, perianal mucosa, neck, head and face, perineum, ear, nose, throat and eyes. Totally 83.8％(150/179) of the children informed the medical staff in time when the pain occurred, hoping to get analgesic treatment; 35.2％ of the children were willing to receive analgesics. In the 179 Children, the children believed that 84.6％ of the pain was related to the treatment procedure; 46.6％ (82/179) was related to the disease itself; and the most unbearable treatment procedure was lumbar puncture/ intrathecal injection. Conclusions Children with malignant tumors have a higher incidence and severity of pain during the treatment of the disease, and the pain is widespread. Most children hope to receive analgesic treatment, but they do not have enough knowledge about analgesics. Medical staff should pay attention to the pain of children with malignant tumors, strengthen pain management, and take measures to reduce and even avoid treatment-related pain.

Objective:To retrieve, evaluate, and summarize the best evidence for peripherally inserted central catheter (PICC) related thrombosis in children.Methods:Guideline websites, relevant society websites, and databases at China and abroad were searched for guidelines, evidence summaries, expert consensuses, and systematic reviews related to thrombosis before and after PICC catheterization in children published up to June 30, 2021 based on evidence-based nursing. The quality of the literature was independently evaluated by 2 researchers with reference to Appraisal of Guidelines for Research and Evaluation InstrumentⅡ and the criteria of the Joanna Briggs Institute (JBI) in Australia (2016) . Data were extracted from the literatures that met the standards through expert demonstration, and the evidence was graded and recommended according to the JBI evidence pre-grading system (2014 edition) .Results:A total of 11 articles were included, including 4 guidelines, 1 systematic review, 1 expert consensus, and 5 evidence summaries. 27 pieces of evidence were summarized from 7 aspects: organizational management, catheter selection, blood vessel selection and puncture, location of catheter tip, physical prevention, drug prevention, and evaluation.Conclusions:This paper summarizes and analyzes the best evidence for PICC-related thrombosis in children and provides an evidence-based reference for the clinical application and practice of PICC-related thrombosis in children.