Objective To explore the experience of self-perceived burden in patients with chronic obstructive pulmonary disease (COPD) and provide evidence for clinical nursing interventions.Methods Indepth interviews were conducted among 17 patients with COPD using phenomenological method of qualitative research.Data were analyzed with the Colaizzi's method.Results 3 themes was identified:self-accusation and guilt,loss of dignity and powerlessness,concern and insecurity.Conclusions Nurses should take the experience of SPB in patients with COPD seriously and take the influence of SPB into account during the process of nursing interventions and evaluation.

Objective To explore the correlation between nursing students' hardiness personality and professional commitment.Methods 1 115 undergraduate nursing students from 3 medical universities in Guangzhou were investigated with the scales of hardiness personality and nursing professional commitment.Results The scores of hardiness personality and professional commitment were (2.55 ± 0.44) and (2.70 ± 0.43),respectively,and both of them were at the middle level.Correlation analysis revealed that hardiness personality was positively related to professional commitment (P＜0.01),and the challenge dimension of hardiness personality had positive predictive effect on professional commitment.Conclusions Nursing educators should take measures to improve students' hardiness personality and professional commitment.It would help maintain the stability of the whole nursing team.

Objective To explore the recovery time of hepatic function in infants with jaundice type of human cytomega-lovirus (HCMV) hepatitis and its influencing factors. Methods The clinical data of 73 infants with jaundice type of HCMV hepa-titis admitted to hospital from February 2005 to October 2012 were retrospectively analyzed. The effects on hepatic function of nine factors including age, sex, liver size, total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), aspar-tate aminotransferase (AST), total bile acid (TBA) and the loads of HCMV DNA were assessed by Kaplan Meier method, and further analyzed by Cox proportional hazards regression model. Results The results of Cox proportional hazards regression showed that age≤3 month (RR=0.27, 95%CI:0.10-0.70), DBil≤90μmol/L (RR=0.16, 95%CI:0.08-0.32), male (RR=0.49, 95%CI:0.26-0.94) and enlarged liver size<3 cm (RR=0.50, 95%CI:0.27-0.93) were independent factors that shorten the time for TBil back to be normal. Furthermore, AST≤120 U/L (RR=0.16, 95%CI:0.08-0.33) and enlarged liver size<3 cm (RR=0.28, 95%CI:0.15-0.49) were independent factors that shorten the time for AST back to be normal. The time for TBil back to be normal was (2.23 ± 1.54) months, which was significantly shorter than that [(3.63 ± 1.93) months] of AST (t=10.37, P<0.001). Conclusions Jaundice type HCMV hepatitis had good outcome and varied in disease course. The recovery of hepatic function was significantly adversely affected by the degree of cholestasis and hepatomegaly as well as AST level, and early treatment was conducive to the recovery.

OBJECTIVETo evaluate the immunogenicity, safety, and dosage of a new inactivated hepatitis A vaccine administered to young adults.

METHODSOne hundred and four normal adult volunteers, seronegative for hepatitis A virus and hepatitis B surface antigen, were randomly assigned to one of three groups. The high-dose group received a primary dose of 1000 units of the new vaccine, the low-dose group received a primary dose of 500 units of the same vaccine, and the Havrix group received a primary dose of 1440 enzyme-linked immunosorbent assay units of Havrix, a licensed inactivated hepatitis A vaccine. All groups received a booster dose of the same vaccine 6 months after the primary dose. Local and systemic adverse reactions, seroconversion rates, and geometric mean titers of hepatitis A virus antibodies were measured in all three groups.

RESULTSLocal and systemic reaction types and rates were similar in all three groups after primary and booster doses, although local reactions were more frequent in the Havrix group following the primary dose. No serious adverse reactions occurred. One month after the primary dose, the seroconversion rate was 87.5% in the high-dose group, 70.0% in the low-dose group, and 50.0% in the Havrix group (P = 0.001, versus the high-dose group). At month 6 (before administration of the booster dose), seroconversion rates were 96.9% in the high-dose group, 65.0% in the low-dose group (P = 0.0029), and 68.8% in the Havrix group (P = 0.007). All subjects in all groups seroconverted by one month after receipt of the booster dose. Geometric mean titers were similar in all three groups at month 1, but were higher in the high-dose group (264 mIU/ml) than those in the Havrix group (135 mIU/ml) at month 6 (P = 0.0013). One month after the booster dose, geometric mean titers in the high-dose group (2747 mIU/ml) were higher than those in the low-dose group (1657 mIU/ml) (P = 0.0223) or in the Havrix group (1316 mIU/ml) (P = 0.01).

CONCLUSIONSThis new inactivated hepatitis A vaccine is immunogenic and safe; two doses of either 500 or 1000 units can induce hepatitis A virus antibodies well above the protection level.

Objective:To compare preoperative portal vein embolization (PVE) using tris-acryl gelatin microspheres (TAGM) versus coils.Methods:From March 2016 to June 2018, 21 consecutive patients with a future liver remnant (FLR) ratio of less than 45% before planned major hepatectomy for malignant or benign liver diseases were enrolled from the First Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital into this study. The patients were divided to receive portal vein embolization (PVE) using TAGM distally and coils proximally (the TC group) and PVE using multiple coils (the CC group). Post-PVE complications, liver function, routine blood tests; FLR hyperplasia, types of liver resection, operation time, intraoperative blood loss, and postoperative complications were compared between the two groups.Results:Eight patients were included in the TC group. There were 4 males and 4 females, with a mean age of (55.3±7.7) years. Of 13 patients included into the CC group, there were 11 males and 2 females, with a mean age of (52.6±11.3) years. There were no significant differences in sex, age, types of hepatic diseases, volume of FLR, ratio of FLR, ratio of standard FLR, types of surgery, operation duration, blood loss, major complications, and liver failure rates between the two groups. All patients in the two groups had successful PVE. The TC group developed effective growth of volume of FLR with one patient who failed to undergo surgery because of tumor progression. In the CC group, four patients failed to undergo liver resection: one patient developed thrombosis of the left branch and main trunk of portal vein; tumor progression occurred in one patient and two patients had insufficient FLR growth. Compared with the CC group, the TC group had a significantly higher volume of FLR hyperplasia [(9.0±2.8) % vs. (5.2±3.8) %, P<0.05], and a faster but insignificant increase in proliferation rate [(11.4±7.1) ml/d vs. (6.9±5.2) ml/d, P>0.05], a greater but insignificant increase in percentage of proliferation [(33.6±20.1) % vs. (20.9±15.1) %, P>0.05]. Conclusions:This study showed that PVE with TAGM plus coils is safe and effective. It induced a better degree of hypertrophy of FLR compared to PVE using multiple coils.

OBJECTIVE: To identify the pathogenesis in two patients of restrictive cardiomyopathy (RCM) using high-throughput sequencing. METHODS: Peripheral blood samples from the two patients and their parents were collected and genomic DNAs were extracted to conduct targeted next generation sequencing or whole exome sequencing. Bioinformation analysis was performed to identify the pathogenic variants in genes associated with cardiomyopathy, which were further validated by Sanger sequencing. RESULTS: By high throughput sequencing, we detected a de novo heterozygous variant c.549+1G>T in TNNI3 gene in patient 1. The variant has not been reported previously and was predicted to be pathogenic in line with American College of Medical Genetics and Genomics (ACMG) guidelines (PVS1+PS2+PM2). Another heterozygous variant c.433C>T (p.Arg145Trp) in TNNI3 gene was identified in patient 2 and his father. The variant had been reported as pathogenic variant in Clinvar and HGMD databases; based on ACMG guidelines, the variant was predicted to be likely pathogenic (PS3+PM1+PP3). CONCLUSION TNNI3 variants may be the causative gene responsible for restrictive cardiomyopathy in the two patients. High throughput sequencing results provide bases for the diagnosis of restrictive cardiomyopathy.
Cardiomyopathy, Restrictive/genetics* ; Child ; Genomics ; Heterozygote ; Humans ; Mutation ; Whole Exome Sequencing

Objective To explore the feasibility and potential application value of establishing the neonatal pig models of islet transplantation under the renal capsule. Methods Nine wild-type neonatal Duroc pigs were selected, including 1 animal as the control (p6307), 6 as islet transplant donors and 2 as islet transplant recipients (p6210, p6207). After islet isolation and differentiation in vitro, islet transplantation under the renal capsule of the pig was performed. Immunosuppressive therapy of tacrolimus (Tac) combined with sirolimus was given after operation. Postoperative body weight, blood glucose and serum creatinine levels of the recipients were monitored. The p6210 recipient neonatal pig was sacrificed at postoperative 4 weeks, while the p6207 recipient and the control neonatal pig were sacrificed at postoperative 8 weeks. The islet grafts under the renal capsule were collected for pathological staining and insulin immunofluorescent staining. Results After islet transplantation under the renal capsule of the pigs, the growth rate of body weight of the recipients was significantly slower than that of the control neonatal pig, accompanied with intermittent symptoms, such as anorexia and diarrhea, etc. However, the blood glucose and serum creatinine levels of the recipients did not significantly differ from preoperative levels and those of the control neonatal pig. Evident islet mass was observed under the renal capsule of the p6210 recipient. Pathological staining and insulin immunofluorescent staining confirmed that the islet mass had the function of secreting insulin, whereas no obvious islet mass could be seen under the renal capsule of the p6207 recipient. Pathological staining detected no evident islet mass, suggesting the possibility of islet transplantation failure caused by rejection in the p6207 recipient. Conclusions The establishment of neonatal pig models of islet transplantation under the renal capsule is a feasible technique, which provides preliminary evidence for the establishment of composite islet-kidney donor graft in pig models for xenotransplantation in the treatment of end-stage diabetic nephropathy.

OBJECTIVE: To establish a method for detecting triphenyl phosphate( TPP) in the workplace air by gas chromatography. METHODS: TPP in the air of workplace was collected with glass fiber filter paper,desorbed with ether,separated by HP-5 gas chromatographic column,and detected by flame photometric detector. RESULTS: This method has good linear range of 12. 50-800. 00 mg/L,with the correlation coefficient of 0. 999 9. The detection limit was 0. 78 mg/L,and the minimum detectable concentration was 0. 09 mg/m3(sample volume was 45 L). Desorption efficiency was 97. 2%-99. 4%; standard recovery rate was 99. 5%-100. 3%. The within-run relative standard deviation( RSD) was 2. 7%-3. 4%and the between-run RSD was 1. 4%-3. 2%. The sampling efficiency was 99. 6%-100. 0%. The samples could be stored at room temperature for at least 14 days. CONCLUSION: The method is simple,accurate and highly sensitive for detecting TPP in workplace air.

Objective:To investigate the reoperation and perioperative management of residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors.Methods:The clinical data of 29 patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors in Affiliated Cancer Hospital of Zhengzhou University from January 2014 to August 2019 were reviewed, including the characteristics of the residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors, surgical method, and perioperative management.Results:Twenty-nine patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors, including 9 cases of epidermoid cysts, 7 cases of dermoid cysts, 10 cases of mature teratomas and 3 cases of malignant cysts (including malignant transformation of caudate cyst and teratoma); The 29 patients underwent posterior approaches for cyst resection in other hospital before, of whom 1 patient underwent posterior combined with transabdominal approach. All of thes patients underwent resection of residual presacral cyst wall and perineal intractable sinus in our hospital, of whom 25 patients underwent a transperineal approach through an arc-shaped incision anterior to the apex of the coccyx, and the other 4 patients underwent transperineal arc-shaped incision combined with transabdominal approach. All of the patients were cured without serious complications occurring, postoperative pathological and the magnetic resonance imaging diagnosis showed that the residual cyst wall and perineal intractable sinus were all completely removed.Conclusion:Appropriate surgical approache and perioperative treatment for the patients with residual cyst wall and perineal intractable sinus are very important to promote the resection of residual cyst wall and the healing of perineal intractable sinus.