Objective To investigate the association between social support and family cohesion, adaptability of rural patients undergoing maintenance hemodialysis (MHD). Methods Between August 2012 and November 2012, 94 patients with incident hemodialysis from rural areas in Hebei province were consecutively recruited in the study. The social support inventory (SSI) and the Chinese version of the family adaptability and cohesion evaluation scales (FACESII-CV) were employed in the investigation 3 months after the start of hemodialysis. Pearson correlation analysis was used to estimate the relationship between social support and familiarity, adaptability in rural MHD patients. Results The score on the family cohesion the adaptability were lower than norm(all P<0.001). The social support was associated with family cohesion and adaptability. The total scores on social support, emotional support and material support were positively associated with the scores on the family cohesion and adaptability (P<0.05). Conclusions The family cohesion and adaptability in rural patients undergoing hemodialysis are both at a lower level and are closely related to emotional and material supports. The higher they get social support, the higher the levels in family cohesion and adaptability.

Objective To investigate and analyze the perioperative nursing of patients with breast cancer, and explore the effectiveness of the application of mind map in perioperative nursing care of patients with breast cancer. Methods The cluster sampling method was employed, and 265 patients with breast cancer receiving radical mastectomy treatment from department of general surgery of the First Affiliated Hospital of Liaoning Medical University were gathered according to the inclusion and exclusion criteria. 137 cases were assigned to test group (May 2014 to April 2015), and 128 cases were assigned to control group (May 2013 to April 2014 ). Nursing work was improved by establishing research group, discussing the design of perioperative nursing mind map and applying mind maps. Effect was evaluated by evaluating the incidence of postoperative complications in patients with breast cancer, the quality of patient′s life and the patient′s satisfaction. Results The incidence of bleeding, seroma, flap necrosis, upper extremity swelling and other postoperative complications of patients with breast cancer in test group was 26.28%(36/128),and that in control group was 73.44%(94/137). The differences between the two groups were of statistical significance (χ2=58.891, P<0.01). The perioperative survival quality scores of physiology, society/family, emotions, function, additions and total in the test group were (2.43 ± 1.09), (2.64±0.97), (2.85±0.97), (2.43±1.09), (2.22±1.12),(2.34±1.13), and that in the control group were (1.89± 1.09), (1.89 ± 1.06), (1.78 ± 0.92), (1.89 ± 1.09), (1.76 ± 1.05), (2.00 ± 1.09)respectively. The differences between the two groups were statistically significant (t=4.664-10.829,P<0.01). The proportion of patient satisfaction in test group was 94.89%(130/137),and that in control group was 82.03%(105/128), respectively. The differences between the two groups were statistically significant (χ2=10.900, P < 0.01). Conclusions Application of mind map in nursing intervention is able to help nurses to grasp the key content and direction of perioperative nursing on patients with breast cancer. More importantly, not only can it improved patients′quality of life and reduce the incidence of postoperative complications, but also increases patients′satisfaction.

Object To study the effects of aerosol inhalation of Compound Salvia Miltiorrhiza Injection (CSMI) on the sputum rheology properties in respiratory tract of postoperative patients after pneumotectomy.Methods Patients in control group inhaled distilled water by ultrasonic nebulizer, patients in the experiment group inhaled CSMI by the same ultrasonic nebulizer.Results The sputum viscosity on the first, third, fourth, and fifth day postoperation (P

KCNJ11 gene mutation was searched in 3 families with neonatal diabetes. A KCNJ11 175 G>A (V59M) mutation was found in one child, while no KCNJ11 gene mutation was found in his parents. No mutation was found in the other two families. The result indicated that KCNJ11 gene mutation might lead to the onset of neonatal diabetes mellitus in Chinese.

Objective To explore the protective mechanisms of Buyanghuanwu decoction (BHD) on heart function by observing its effect on MIRI rabbits. Methods The rabbits were randomly divided into three groups, including sham group, model group, and BHD group. After pretreatment for one week, the model of myocardial ischemia reperfusion injury was established by ligating the branch of left coronary arter-y. The changes of electrocardiography were observed, and the values of LVSP, + dp/dtmax, - dp/dtmax were recorded and compared. Results Compared with the model group, the values of LVSP, + dp/dtmax, - dp/dtmax in BHD group were significantly increased (P<0.01 ). Conclusion BHD can improve heart function of MIRI rabbits.

Lifitegrast is a novel inhibitor of integrin,which can take effect by blocking the binding of intercellular adhesion molecule 1 and integrin lymphocyte function associated antigen 1.In July 2016,the U.S.Food and Drug Administration (FDA) officially approved the application of lifitegrast ophthalmic solution 5％ (commodity name XiidraTM).Clinical trials of the drug include a 12-week phase II clinical trial and three 12-week phase III clinical trials for dry eye disease patients.The results of clinical trials have demonstrated the efficacy and safety of the drug.Lifitegrast is the first FDA approved drug to improve and treat dry eye symptoms,and other similar drug is only cyclosporine.It is believed that in the near future clinical application of lifitegrast will be more extensive.

Objective: Victims with shock-able initial arrest rhythms (ventricular fibrillation or pulse-less ventricular tachycardia, VF/VT) have much better outcomes from out-of-hospital cardiac arrest (OHCA) than those with non-shock-able initial rhythms (pulse-less electrical activities, PEA or asystole). Prompt defibrillation is believed pivotal to terminate lethal shock-able arrest rhythms. In this study, we were to identify those pre-hospital epidemiological factors which were associated with likelihood of shock-able rhythms first recorded when out-of-hospital cardiac arrest occurred. Methods: A multicenter, secondary, retrospective and observational analysis was performed on all adult non-traumatic OHCA in the Resuscitation Outcome Consortium (ROC) PRIMED study from June 2007 through November 2009. Of a total of 17 177 OHCA cases in PRIMED study, 13 421 of them were enrolled in this study when those OHCA patients with DNR order, or initial rhythms unknown, or arrest caused by obvious cause were excluded. We reported their demographics and episode characteristics for all enrolled cases. Multivariable logistic regression was employed to identify factors which were associated with likelihood of VF/VT recorded as shock-able initial rhythms. Results: Among 13 421 adult non-traumatic OHCA cases with initial rhythms recorded, 3 527 (26.3%) of them had shock-able rhythms, while 9 894 (73.7%) patients were in non-shock-able rhythms. Of the OHCA with shock-able arrest rhythms, 1 850(52.5%) obtained return of spontaneous circulation (ROSC) in the field, while 912 (25.9%) survived to hospital discharge. On the other hand, 2489(25.2%) of the OHCA with non-shock-able arrest rhythms obtained ROSC in the field, while 325 (3.3%) of them survived to hospital discharge. Multivariable regression analysis revealed those factors which indicated likelihood of shock-able rhythms recorded were: age(OR: 0.991,95%CI 0.988-0.993), male gender (OR1.887,95%CI1.718-2.073), pre-hospital Emergency Medical System(EMS) response time(OR0.950,95%CI 0.931-0.970), cardiac arrest witnessed by EMS providers(OR1.709,95%CI 1.423-2.054) or bystander(OR3.199,95%CI 2.921-3.504) and those with bystanders CPR (OR1.357,95%CI 1.239-1.487),public place of cardiac arrest (OR2.705,95%CI 2.437-3.003). Conclusions Some demographics and pre-hospital characteristics were proved associated with likelihood of shock-able arrest rhythms first recorded in OHCA victims, which might help develop corresponding strategies to deliver prompt shock on initially shock-able patients and improve their outcomes.

Objective:To compare the difference of blood amino acids and acylcarnitine levels between small-for-gestational-age (SGA) and appropriate-for-gestational age (AGA) full-term newborns, and to explore the changes of the blood metabolism spectrum of full-term SGA, so as to provide evidence for clinical intervention.Methods:Seventy-nine full-term SGA newborns born in the Sixth Affiliated Hospital of Sun Yat-Sen University from January to December 2018 were selected as the study objects.Seventy-nine gestational age-and gender-matched healthy full-term AGA newborns born in the same hospital at the same time were selected as the control group.The dry blood spot samples were collected and detected by tandem mass spectrometry on the third day after birth.The differences between two groups and considerable biomarkers were explored by the orthogonal partial least squares discriminant analysis (OPLS-DA).Results:The birth weight of SGA newborns was (2.5±0.2) kg, and that of AGA newborns was (3.2±0.3) kg.OPLS-DA model analysis showed that 12 kinds of blood metabolites were identified which possessed the biggest weight discriminating the full-term SGA group from the AGA group, and the ratios of these blood metabolites of two groups were compared as follows: propionylcarnitine (0.34±0.13 vs. 0.42±0.15), tyrosine [0.24(0.18, 0.27) vs.0.28(0.22, 0.37)], free carnitine (0.43±0.14 vs. 0.37±0.12), valine [0.39(0.35, 0.45) vs.0.44(0.36, 0.53)], octanoylcarnitine (0.33±0.13 vs. 0.29±0.09), myristoylcarnitine (0.35±0.12 vs. 0.31±0.10), butylcartine (0.37±0.13 vs. 0.41±0.14), 3-hydroxyisovlerylcartine[0.35(0.25, 0.43) vs.0.35(0.26, 0.45)], decenoylcarnitine (0.26±0.13 vs. 0.23±0.08), isovalerylcarnitine[0.33(0.26, 0.34) vs.0.33(0.30, 0.35)], leucine [0.38(0.30, 0.47) vs.0.40(0.33, 0.48)]and methionine (0.42±0.14 vs. 0.46±0.15). The level of propionylcarnitine ( t=3.920), tyrosine ( Z=3.536) and valine ( Z=2.838) in the full-term SGA group were significantly lower than those in the AGA group, while the levels of free carnitine ( t=-2.863), octanoylcarnitine ( t=-2.266) and myristoylcarnitine ( t=-2.194) in the full-term SGA group were significantly higher than those in the AGA group (all P<0.05). Conclusions:The concentration of amino acids and acylcarnitine in the blood of SGA newborns is different from that in AGA newborns.Aromatic amino acids and branched chain amino acids should be added in full-term SGA nutrition support as they can meet the energy metabolism by mobilizing medium and long chain fatty acids in the early stage.

Objective:To detect the genes of common genetic diseases in newborns with the high-throughput sequencing technology based on target gene capture, to study the incidence rate of such diseases, the carrying rate and variant types of pathogenic mutations related to such diseases, and to explore the application value of the high-throughput sequencing technology in screening genetic diseases of newborns.Methods:The heel blood of 1 793 newborns born in Guangdong province from June 2019 to April 2020 were collected, and the exon regions of 138 common genetic disease-related genes in neonates were detected using the high-throughput sequencing technology based on target gene capture.The pathogenicity of the mutations was interpreted according to the " Classification Criteria and Guidelines for Genetic Variation(2017)" , in which known disease and probable disease were considered as positive mutations.The positive mutations were verified by Sanger sequencing technology, and the test results were analyzed with statistical methods.Results:Among the 1 793 newborns, 978 were male and 815 were female.A total of 158 positive cases were screened(8.81%), and 11 positive diseases were detected.Among the positive diseases, there were 41 cases(2.29%)of autosomal recessive deafness type 1A, 40 cases(2.23%)of Gilbert syndrome or Crigler-Najjar syndrome, and 33 cases(1.84%)of glucose-6-phosphate dehydrogenase deficiency(1.84%), 19 cases(1.06%)of familial hypercho-lesterolemia, 18 cases(1.00%) of sodium taurocholate cotransporter peptide deficiency disease, 2 cases(0.11%)of mitochondrial non-syndromic deafness, 2 cases(0.11%)of Citrin deficiency, 1 case(0.06%)of holocarboxylase synthase deficiency, 1 case(0.06%)of β-thalassemia and 1 case(0.06%)of metachromatic leukodystrophies.Of all studied cases, 972 carried one or more positive mutations, involving 85 kinds of diseases in total.The diseases with a high carrying rate were Gilbert syndrome or Crigler-Najjar syndrome(359 cases, 20.02%), autosomal recessive deafness type 1A(302 cases, 16.84%), and sodium taurocholate cotransport peptide deficiency disease(291 cases, 16.22%). The high-frequency mutation sites were UGT1A1 gene c. 211G> A, GJB2 gene c .109G> A and SLC10A1 gene c. 800C> T. Conclusions:The common genetic diseases detected in neonates from Guangdong province are autosomal recessive deafness type 1A, Gilbert syndrome or Crigler-Najjar syndrome, glucose-6-phosphate dehydrogenase deficiency, familial hypercholesterolemia, and sodium taurocholate cotransport peptide deficiency.There are high-frequency carrying mutation sites in the population.Preliminary genetic screening of common neonatal genetic diseases can accumulate data and experience for the development of newborn genetic screening.

Objective:To investigate the association between metabolic syndrome and the risk of early renal function injury in chronic kidney disease(CKD) in the elderly.Methods:A retrospective cohort was established based on health check-up data of 4 495 elderly residents in Mengzi City, Yunnan Province from January 2016 to December 2018. The medial history, living habits, and related physical examination information were collected. Cox hazard regression model was used to explore the association between metabolic syndrome, along with its components, and the early renal function injury in CKD. Results:The median age of the elderly was 71.00(67.00, 75.00) years, with metabolic syndrome detection rate of 21.98%. Early renal function injury of CKD developed in 1 300(28.92%) subjects during the follow-up. Univariate Cox regression showed that the number of metabolic syndrome components was associated with the risk of early kidney development in CKD. The HRs were 1.23 (95% CI 1.03-1.47, P=0.022) with 1 component, 1.54 (95% CI 1.28-1.84, P<0.001) with 2, and 1.38 (95% CI 1.14-1.67, P<0.001) with 3 or more. Multivariate Cox regression showed that elevated fasting triglycerides( HR=1.20, 95% CI 1.07-1.36, P=0.003) and lower high density lipoprotein-cholesterol(HDL-C; HR=1.25, 95% CI 1.09-1.43, P=0.002) were risk factors for early kidney injury in CKD, while doing some physical activity( HR=0.57, 95% CI 0.33-0.98, P=0.042), or on daily basis( HR=0.57, 95% CI 0.49-0.66, P<0.001) was a protective factor for early kidney injury in CKD. Conclusion:The abnormality of one or more metabolic components can significantly increase the risk of early kidney injury in the elderly with CKD. Elevated triglyceride and decreased HDL-C may be the risk factors.