Objective To observe the effect and value of erythropoietin (EPO) with monosialotetrahexosylganglioside (GM 1) on hypoxic ischemic encephalopathy (HIE) of newborn.Methods Seventy cases of newborn with HIE were selected and divided into research group and control group based on different treatment methods,35 cases of each group.Research group were given EPO and GM 1:newborn were given subcutaneous injection of 300 U/(kg · w) EPO,3 times a week,with duration of two weeks;daily dose of GM1 was 20 mg,with intravenous injection for consecutive 2 weeks.Control group were given separate GM1:newborn were given GM1 intravenous injection,with daily dose of 20 mg for consecutive 2 weeks.Neonatal behavioral neurological assessment (NBNA) were performed on all newborn patients at the 14th day after born.At the 10th months after born,Gesell Scale and the Bayley Scales of Infant Development were given to all patients.Results Total effective rate of research group was 97.14％ (34/35),and 82.86％ (29/35) for control group,the difference was statistically significant (x2=3.97,P＜0.05).At the 14th day after born,the behavior ability,passive muscle tension,active tension,primitive reflexes and general assessment scores of the research group were (10.20± 1.67) points,(8.28 ± 1.60) points,(8.11 ± 1.51) points,(4.57 ± 1.97) points and (6.12 ± 1.46) points,of the control group were (9.32 ± 1.51) points,(7.33 ± 1.54) points,(7.14± 0.98) points,(3.46± 1.58) points and (5.05 ± 1.35),the differences were statistically significant (t =2.31,2.53,3.19,2.60,3.18;P＜0.05).At the 10 months after born,the DQ scores of big sports energy district,fine motor energy district,language ability district,personal and social adaptation district and social energy district of research group were (90.01 ± 7.76) points,(90.32± 6.77) points,(93.03 ± 6.28) points,(94.88 ± 5.19) points and (92.87±7.36) points,of control group were (84.91 ± 6.51) points,(86.92 ± 6.56) points,(88.13 ± 5.85)points,(88.87±6.14) points and (88.04±7.03),the differences were statistically significant (t =2.98,2.13,3.38,4.42,2.81;P ＜ 0.05).At the 10 months after born,the Mental developmental index (MDI) and Psychomotor development index(PDI) of research group were (92.87±7.05) points and (94.45±5.78) points,of control group were (89.23 ± 6.89) points and (90.26 ± 6.03) points,the differences between the two groups were statistically significant(t =2.18,2.97;P＜0.05).Conclusion EPO with GM 1 on the treatment of HIE is of high clinical efficiency.In addition,it promotes early recovery of neurological symptoms in newborn with HIE,with long-term effects on the nervous system of children.

BACKGROUND:Hereditary factor occupies a certain position in suicidal behavior of depression. The researches in the past are focused on the hereditary effect on bipolar depression suicide.How do hereditary patterns and effects work in suicidal behavior in unipolar depression?OBJECTIVE: To probe into hereditary patterns and effects on suicidal behavior in unipolar depression.DESIGN:Retrospective investigation.SETTING:A municipal psychiatric hygienic centerPARTICIPANTS:Unipolar depression group included 115 outpatients and inpatients diagnosed in Wuxi Psychiatric Hygienic Center from June 1st 1983 to May 31st 2002.The diagnosis tallied with Standards on Depression Onset in Categories and Diagnostic Standards on Psychiatric Disturbance in China of 3rd Edition and with Standards on Severe Depression Onset in Manual of Diagnosis and Statistics of Psychiatric Disturbance in America of 4th Edition.The attack frequency of all the cases ≥ 3 times or the cases had been relieved ≥8 years after a couple of attacks.METHODS:The patients who tallied with the standards on unipolar depression received the investigation in every family tree under the instruction of 2 physicians-in-charge and more than 2 physicians and filled up the self-made investigation form of psychiatric family tree,including mainly the data of social demography of patients and their first grade relatives,characters of disease onset,frequency of attack,history of treatment and suicide. After re-diagnosed by 2 physicians-incharge and more than 2 physicians and checked by one physician-incharge,the cases were collected in patient group. The interview was carried on for the patients with suicidal behavior among all of the survived patients (107 cases) and first grade relatives (14 cases).The interview (337 cases) and investigation with letter (380 cases) were carried on for the first grade relatives without suicidal behavior. The investigation forms of 13 dead cases (8 cases of patients, 5 cases of first-grade relatives) were provided and filled-up by one or two first grade relatives. Two researchers interviewed the cases in the control,inquired the first grade relatives and filled up the investigation form of family tree.Single factor analysis was used for all the data and Falconer pattern of polygenetic threshold-value theory was used to estimate hereditary rate and standard error in suicidal behavior.Separation analysis in medical hereditary mathematic method and polygenetic threshold-value theory were applied to discuss the hereditary patterns.MAIN OUTCOME MEASURES:Hereditary effects and patterns of suicidal behavior in unipolar depressed patients.RESULTS:Suicidal risk of unipolar depressed patients(51.30%,59/115)was higher than their first grade relatives (2.58%,19/736) (x2=283.16,P ＜ 0.01).Suicidal risk of the first grade relatives (2.58%,19/736) of unipolar depressed patients was higher than the control (0.12%,3/2469)(x2=50.36,P ＜ 0.01).Suicidal risk of the first grade relatives of the patients with suicidal behavior (3.8%,14/372) was higher than that of the first grade relatives of the patients without suicidal behavior (1.4%,5/363)(x2=4.14,P＜ 0.05).The weighted average hereditary rate and standard error was (70.16±0.79)% for suicidal behavior in unipolar depression.The predictive morbidity of suicidal behavior in the first grade relatives was 3.1% and the real morbidity was 2.6%,which did not indicate significant difference (u =0.766, P ＞ 0.05).CONCLUSION:Suicidal behavior of unipolar depression presents obvious hereditary effects and its hereditary patterns tally with polygenetic inheritance.

Objective:To systematically evaluate the qualitative study of the real experience of patients with enteral nutrition after gastro/jejunostomy and their caregivers and to deeply understand the real feelings and physical and mental experience of patients and caregivers.Methods:Databases were searched including PubMed, Embase, CINAHL, The Cochrane Library, Web of Science, PsycINFO, CNKI, Wanfang Database, VIP Database and CBM from inception to September 30th, 2019. To collect the qualitative studies on the real experience of patients with enteral nutrition after gastro/jejunostomy and their caregivers. According to the inclusion and exclusion criteria, the included literature was determined, the literature was evaluated according to the quality evaluation criteria of qualitative research of the JBI Evidence-based Health Care Center, and the results were integrated using a collective integration method.Results:A total of 11 studies were included and 37 results were extracted. Based on the quality of life theory, the topics extracted are as follows: patients with enteral nutrition after gastro/jejunostomy and their caregivers experienced dynamic cycle of change and challenge, coping and adaptation, demand and support in the domain of health and function, psychology/spiritual, socioeconomic and family.Conclusions:The four domains of quality of life of patients and caregivers were affected during enteral nutrition after gastro/jejunostomy. In particular, patients and caregivers showed strong inner and information needs in the psychological/spiritual and socioeconomic domain. It is suggested that medical staff should provide effective psychological, emotional and information support in disease treatment and nursing, in order to improve the quality of life of patients and caregivers.

Objective:To explore the symptom experience of patients with acute coronary syndrome before diagnosis, in order to improve their early recognition ability, timely medical treatment rate and formulate relevant measures to provide reference.Methods:Semi-structured interview was performed in 18 patients with acute coronary syndrome from August 12 2020 to September 8 in Shanxi Provincial people′s Hospital using phenomenological research, and the data were analyzed under the guidance of symptom experience model.Results:A total of four themes were summarized: symptom perception: diseases being easily predicted, symptom experiences being diverse and diseases being easily overlooked; symptom evaluation: correct evaluation and evaluation bias; symptom response: self-response and family-society support; reflection on the process of symptom experience:medical behaviour and lack of awareness of disease.Conclusions:At present, the identification of acutecoronary syndrome is still a challenge. Patients should enrich relevant knowledge, pay attention to their own symptom experience, make the correct evaluation and deal with it effectively. Medical workers should carry out relevant education to improve the ability of patients to identify diseases.

OBJECTIVETo correlate the clinical features of patients with acute myeloid leukemia (AML) with mutations of FLT3-ITD, NPM1, CEBPA, c-KIT, DNMT3A and ND4 genes as well as chromosomal aberrations.

METHODSSomatic mutations of aforementioned genes in 412 newly diagnosed AML patients were detected with PCR and direct sequencing. All patients were also subjected to R-banding chromosomal analysis. The results were correlated with the clinical features and prognosis of the patients.

RESULTSThe mutation rates of FLT3-ITD, NPM1, CEBPA, c-KIT, DNMT3A and ND4 were 9.0% (26/289), 19.1% (50/262), 18.9% (34/180), 3.4% (7/208), 6.6% (9/137) and 6.9% (4/58), respectively. Patients with poor prognosis based on genetic mutations had lower blood platelet count than those with intermediate and good prognosis (P=0.001 and P=0.001, respectively). None of the three groups attained median overall survival (OS) (P> 0.05). The complete remission (CR) was similar among the three groups (P> 0.05). For patients with different prognosis based on cytogenetic findings, white blood cell count in those with intermediate prognosis was higher than those with good and poor prognosis (P< 0.001 and P=0.004, respectively), while the blood platelet count of the intermediate group was higher than that of the group with good prognosis (P=0.018). No significant difference was found among the three groups in terms of hemoglobin level (P> 0.05). The group with poor prognosis has attained shorter OS compared with those with good and intermediate prognosis (P< 0.001 and P=0.003, respectively). However, the CR rate of the group with good prognosis was higher than that of the intermediate group (P=0.001). For the group with intermediate prognosis, presence of genetic mutations did not correlate with the clinic characteristics such as white blood cell count, blood platelet count, hemoglobin level, OS and CR rate (P> 0.05 for all comparisons).

CONCLUSIONGenetic mutations combined with cytogenetic analysis can facilitate the prognosis and personalized treatment for patients with AML.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Leukemia, Myeloid, Acute ; genetics ; mortality ; Male ; Middle Aged ; Mutation ; Prognosis ; Young Adult

Objective To analyze the differences in mechanical properties of arterial vessels at different sites and the effects of different test methods on the experimental results. Methods A unique fixtures based on characteristics of artery shape was designed. The porcine thoracic aorta and common carotid arteries were applied with uniaxial tensile tests under 4 different states (tubular vessels in axial and radial direction and sheets in axial and circumferential direction), and data fitting analysis was conducted on their nonlinearity. Results The mechanical properties of aorta vessels under tubular state were stronger than those under sheet state, and the difference in such numerical results became more significant with the diameter of the tube decreasing. Conclusions The experiment results, provide more comprehensive and reliable vascular mechanical parameters to provide data support for constructing finite element model and constitutive relationship of blood vessels, and guide design and manufacture of tissue engineered vascular grafts. At the same time, it is also beneficial to study and analyze the potential pathophysiology of certain vascular diseases, which will help doctors to present better therapeutic effects in clinical treatment.